Provider Demographics
NPI:1760625636
Name:MEMORIAL EYE, P.A.
Entity Type:Organization
Organization Name:MEMORIAL EYE, P.A.
Other - Org Name:SHIP MY CONTACTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLBROOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-944-0050
Mailing Address - Street 1:2470 GRAY FALLS DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-6512
Mailing Address - Country:US
Mailing Address - Phone:281-944-0050
Mailing Address - Fax:281-944-0055
Practice Address - Street 1:2470 GRAY FALLS DR
Practice Address - Street 2:SUITE 150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-6512
Practice Address - Country:US
Practice Address - Phone:281-944-0050
Practice Address - Fax:281-944-0055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3947TG332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier