Provider Demographics
NPI:1356535488
Name:VISION CENTERS OF HOUSTON DEERBROOK PLLC
Entity type:Organization
Organization Name:VISION CENTERS OF HOUSTON DEERBROOK PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-446-5800
Mailing Address - Street 1:20119-A HIGHWAY 59 NORTH
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338
Mailing Address - Country:US
Mailing Address - Phone:281-446-5800
Mailing Address - Fax:281-259-5557
Practice Address - Street 1:20119-A HIGHWAY 59 NORTH
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338
Practice Address - Country:US
Practice Address - Phone:281-446-5800
Practice Address - Fax:281-259-5557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX03077TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3077TGOtherTEXAS OPTOMETRY LICENSE
TX3077TGOtherTEXAS OPTOMETRY LICENSE