Provider Demographics
NPI:1619157708
Name:HOUSTON OPTIC, PLLC
Entity Type:Organization
Organization Name:HOUSTON OPTIC, PLLC
Other - Org Name:HOUSTON EYE ASSOCIATES OPTICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF INFORMATION OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MERKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-668-6828
Mailing Address - Street 1:2855 GRAMERCY ST STE 400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-1756
Mailing Address - Country:US
Mailing Address - Phone:713-668-6828
Mailing Address - Fax:
Practice Address - Street 1:5420 DASHWOOD DR STE 101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081
Practice Address - Country:US
Practice Address - Phone:713-668-9118
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOUSTON OPTIC, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-06
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
TX332H00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1558476788OtherGROUP NPI
TX208243001Medicaid
TX206292901OtherTPI
TX6006810007Medicare PIN
TX1558476788OtherGROUP NPI
TX206292901OtherTPI