Provider Demographics
NPI:1790893238
Name:EYECARE LEADERS PA
Entity Type:Organization
Organization Name:EYECARE LEADERS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:QUYET
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:713-947-8718
Mailing Address - Street 1:10603 FUQUA ST STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-2403
Mailing Address - Country:US
Mailing Address - Phone:713-947-8718
Mailing Address - Fax:713-715-6636
Practice Address - Street 1:10603 FUQUA ST STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-2403
Practice Address - Country:US
Practice Address - Phone:713-947-8718
Practice Address - Fax:713-715-6636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5149TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
117725OtherEYEMED VISION CARE
TX0932741-01Medicaid
915244OtherBLOCK VISION OF TEXAS
=========OtherSUPERIOR VISION
117725OtherEYEMED VISION CARE
TX=========OtherVSP PROVIDER