Provider Demographics
NPI:1437331477
Name:M & M OPTICAL INC
Entity Type:Organization
Organization Name:M & M OPTICAL INC
Other - Org Name:FALCON PASS VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MAXWELL-MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-461-3937
Mailing Address - Street 1:2409 FALCON PASS
Mailing Address - Street 2:SUITE 180
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-6238
Mailing Address - Country:US
Mailing Address - Phone:281-461-3937
Mailing Address - Fax:281-461-6084
Practice Address - Street 1:2409 FALCON PASS
Practice Address - Street 2:SUITE 180
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-6238
Practice Address - Country:US
Practice Address - Phone:281-461-3937
Practice Address - Fax:281-461-6084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4123TG152W00000X, 152WC0802X, 152WP0200X, 152WS0006X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Single Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Single Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty