Provider Demographics
NPI:1841210697
Name:KAUFMAN EYE PA
Entity Type:Organization
Organization Name:KAUFMAN EYE PA
Other - Org Name:WOODLANDS EYE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNDLACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-367-2020
Mailing Address - Street 1:4775 W PANTHER CREEK DR
Mailing Address - Street 2:SUITE 230B
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-3592
Mailing Address - Country:US
Mailing Address - Phone:281-367-5335
Mailing Address - Fax:281-292-4688
Practice Address - Street 1:4775 W PANTHER CREEK DR
Practice Address - Street 2:SUITE 230B
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-3592
Practice Address - Country:US
Practice Address - Phone:281-367-5335
Practice Address - Fax:281-292-4688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1974T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0403010001Medicare NSC
TX00218ZMedicare ID - Type UnspecifiedGROUP ID #