Provider Demographics
NPI:1558461608
Name:CY FAIR VISION CARE, PC
Entity Type:Organization
Organization Name:CY FAIR VISION CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-970-6900
Mailing Address - Street 1:9105 W SAM HOUSTON PKWY N
Mailing Address - Street 2:800
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-6309
Mailing Address - Country:US
Mailing Address - Phone:281-970-6900
Mailing Address - Fax:281-970-6959
Practice Address - Street 1:9105 W SAM HOUSTON PKWY N
Practice Address - Street 2:800
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064-6309
Practice Address - Country:US
Practice Address - Phone:281-970-6900
Practice Address - Fax:281-970-6959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W474Medicare ID - Type Unspecified