Provider Demographics
NPI:1134203615
Name:HOPE FACIAL PLASTIC & EYE PHYSICIANS OF TEXAS
Entity type:Organization
Organization Name:HOPE FACIAL PLASTIC & EYE PHYSICIANS OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FRIEND
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:STITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-485-5970
Mailing Address - Street 1:2510 WESTMINISTER ST
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-4518
Mailing Address - Country:US
Mailing Address - Phone:281-412-0163
Mailing Address - Fax:
Practice Address - Street 1:2510 WESTMINISTER ST
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-4518
Practice Address - Country:US
Practice Address - Phone:281-412-0163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4553207W00000X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Not Answered208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXJ4553OtherSTATE LICENSE
TXJ4553OtherSTATE LICENSE
TXG08197Medicare UPIN