Provider Demographics
NPI:1710527361
Name:TSO-ENERGY CORRIDOR PC
Entity Type:Organization
Organization Name:TSO-ENERGY CORRIDOR PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:EUDE
Authorized Official - Middle Name:A
Authorized Official - Last Name:OSSORIO
Authorized Official - Suffix:
Authorized Official - Credentials:CONSULTANT
Authorized Official - Phone:832-934-1166
Mailing Address - Street 1:14637 MEMORIAL DR STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-7522
Mailing Address - Country:US
Mailing Address - Phone:832-770-4926
Mailing Address - Fax:281-493-0043
Practice Address - Street 1:14637 MEMORIAL DR STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-7522
Practice Address - Country:US
Practice Address - Phone:832-770-4926
Practice Address - Fax:281-493-0043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-12
Last Update Date:2020-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty