Provider Demographics
NPI:1508535691
Name:KELECHI EYE ASSOCIATES LLC
Entity Type:Organization
Organization Name:KELECHI EYE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:K
Authorized Official - Last Name:AKPUNKU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:469-396-5409
Mailing Address - Street 1:KELECHI EYE ASSOCIATES LLC
Mailing Address - Street 2:20418 CHATFIELD BEND WAY
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-2249
Mailing Address - Country:US
Mailing Address - Phone:469-396-5409
Mailing Address - Fax:470-771-5398
Practice Address - Street 1:ATHENS FAMILY EYE CARE
Practice Address - Street 2:1405 E TYLER ST
Practice Address - City:ATHENS
Practice Address - State:TX
Practice Address - Zip Code:75751-4613
Practice Address - Country:US
Practice Address - Phone:469-396-5409
Practice Address - Fax:470-771-5398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center