Provider Demographics
NPI:1639369010
Name:BELLAIRE EYE CARE INC.
Entity Type:Organization
Organization Name:BELLAIRE EYE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-934-1166
Mailing Address - Street 1:2726 BISSONNET ST
Mailing Address - Street 2:240-228
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1319
Mailing Address - Country:US
Mailing Address - Phone:832-934-1166
Mailing Address - Fax:832-934-1161
Practice Address - Street 1:2726 BISSONNET ST
Practice Address - Street 2:240-228
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-1319
Practice Address - Country:US
Practice Address - Phone:832-934-1166
Practice Address - Fax:832-934-1161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7128TG152W00000X
TX7522T152WC0802X
TXE4710207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX IDENTIFICATION NUMBER