Provider Demographics
NPI:1720174485
Name:EYE CENTER OF TEXAS LLP
Entity Type:Organization
Organization Name:EYE CENTER OF TEXAS LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KRUPPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-357-7249
Mailing Address - Street 1:6565 WEST LOOP SOUTH
Mailing Address - Street 2:SUITE 650
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401
Mailing Address - Country:US
Mailing Address - Phone:713-797-1010
Mailing Address - Fax:713-797-6200
Practice Address - Street 1:6565 WEST LOOP SOUTH
Practice Address - Street 2:SUITE 650
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401
Practice Address - Country:US
Practice Address - Phone:713-797-1010
Practice Address - Fax:713-797-6200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179422401Medicaid
TX179422401Medicaid