Provider Demographics
NPI:1942478151
Name:SPRING OPTICAL P. C.
Entity Type:Organization
Organization Name:SPRING OPTICAL P. C.
Other - Org Name:TEXAS STATE OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PERDUE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-370-9083
Mailing Address - Street 1:18555 KUYKENDAHL RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-5200
Mailing Address - Country:US
Mailing Address - Phone:281-370-9083
Mailing Address - Fax:281-251-9868
Practice Address - Street 1:18555 KUYKENDAHL RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-5200
Practice Address - Country:US
Practice Address - Phone:281-370-9083
Practice Address - Fax:281-251-9868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2394T332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier