Provider Demographics
NPI:1689710196
Name:MODERNEYES VISION CENTER
Entity Type:Organization
Organization Name:MODERNEYES VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-893-1233
Mailing Address - Street 1:4603 FM 1960 RD W # C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-4603
Mailing Address - Country:US
Mailing Address - Phone:281-893-1233
Mailing Address - Fax:281-893-1232
Practice Address - Street 1:4603 FM 1960 RD W # C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4603
Practice Address - Country:US
Practice Address - Phone:281-893-1233
Practice Address - Fax:281-893-1232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2007-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5718T152W00000X
TX4823TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty