Provider Demographics
NPI:1013007467
Name:HOU, SANDRA SHINA (OD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:SHINA
Last Name:HOU
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2059 CATTAIL CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-3820
Mailing Address - Country:US
Mailing Address - Phone:248-852-0445
Mailing Address - Fax:248-852-0445
Practice Address - Street 1:2001 W MAPLE RD
Practice Address - Street 2:WAL MART VISION CENTER
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-7100
Practice Address - Country:US
Practice Address - Phone:248-435-4126
Practice Address - Fax:248-435-4162
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004170152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist