Provider Demographics
NPI:1942421599
Name:SOUTHEAST EYE ASSOCIATES, PA
Entity Type:Organization
Organization Name:SOUTHEAST EYE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:CABLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-995-0042
Mailing Address - Street 1:7707 FANNIN ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1926
Mailing Address - Country:US
Mailing Address - Phone:713-995-0042
Mailing Address - Fax:713-995-0548
Practice Address - Street 1:7707 FANNIN ST
Practice Address - Street 2:SUITE 107
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1926
Practice Address - Country:US
Practice Address - Phone:713-995-0042
Practice Address - Fax:713-995-0548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE0225207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00L39BOtherBCBS NUMBER
TX011900385OtherMEDICARE RAILROAD
TX011900385OtherMEDICARE RAILROAD
TX011900385OtherMEDICARE RAILROAD
TX00L39BOtherBCBS NUMBER