Provider Demographics
NPI:1700074655
Name:JAMES A OEVERMANN, O.D. PC
Entity Type:Organization
Organization Name:JAMES A OEVERMANN, O.D. PC
Other - Org Name:CYPRESS FAMILY EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:OEVERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-550-4141
Mailing Address - Street 1:7035 BARKER CYPRESS RD
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-1209
Mailing Address - Country:US
Mailing Address - Phone:281-550-4141
Mailing Address - Fax:281-550-9771
Practice Address - Street 1:7035 BARKER CYPRESS RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-1209
Practice Address - Country:US
Practice Address - Phone:281-550-4141
Practice Address - Fax:281-550-9771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5440TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00173VMedicare PIN