Provider Demographics
NPI:1477855740
Name:CHRISTY'S EYE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:CHRISTY'S EYE ASSOCIATES, LLC
Other - Org Name:TEXAS STATE OPTICAL MAGNOLIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:Y
Authorized Official - Last Name:JEW
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-946-2020
Mailing Address - Street 1:6519 FM 1488 RD
Mailing Address - Street 2:SUITE 503
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-3263
Mailing Address - Country:US
Mailing Address - Phone:281-946-2020
Mailing Address - Fax:281-946-2025
Practice Address - Street 1:6519 FM 1488 RD
Practice Address - Street 2:SUITE 503
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-3263
Practice Address - Country:US
Practice Address - Phone:281-946-2020
Practice Address - Fax:281-946-2025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-18
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7600TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB114853Medicare PIN