Provider Demographics
NPI:1760843817
Name:TSO RAYFORD PA
Entity Type:Organization
Organization Name:TSO RAYFORD PA
Other - Org Name:TEXAS STATE OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHONG
Authorized Official - Middle Name:Q
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:OD/OWNER
Authorized Official - Phone:832-810-2020
Mailing Address - Street 1:3535 RAYFORD ROAD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386
Mailing Address - Country:US
Mailing Address - Phone:832-810-2020
Mailing Address - Fax:832-644-5312
Practice Address - Street 1:3535 RAYFORD ROAD
Practice Address - Street 2:SUITE 500
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386
Practice Address - Country:US
Practice Address - Phone:832-810-2020
Practice Address - Fax:832-644-5312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty