Provider Demographics
NPI:1518443175
Name:MONROE EYE SITE INC
Entity Type:Organization
Organization Name:MONROE EYE SITE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASMA
Authorized Official - Middle Name:K
Authorized Official - Last Name:ALSALAMEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-773-5055
Mailing Address - Street 1:1619 STONE MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-3046
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 HIGHWAY 332 W STE 1410
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-4016
Practice Address - Country:US
Practice Address - Phone:979-480-0815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-17
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty