Provider Demographics
NPI:1720382401
Name:MOBILE OPHTHALMIC UNIT LLC
Entity Type:Organization
Organization Name:MOBILE OPHTHALMIC UNIT LLC
Other - Org Name:MOBILE OPHTHALMIC UNIT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-391-3313
Mailing Address - Street 1:5919-B GEORGE BUSH DRIVE
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-1937
Mailing Address - Country:US
Mailing Address - Phone:281-391-3313
Mailing Address - Fax:
Practice Address - Street 1:5919-B GEORGE BUSH DRIVE
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-1937
Practice Address - Country:US
Practice Address - Phone:281-391-3313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6525420001Medicare NSC