Provider Demographics
NPI:1841629532
Name:GINA T DO OD PLLC
Entity type:Organization
Organization Name:GINA T DO OD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:T
Authorized Official - Last Name:DO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-859-9136
Mailing Address - Street 1:6839 HIGHWAY 6 N
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-1315
Mailing Address - Country:US
Mailing Address - Phone:281-859-9136
Mailing Address - Fax:281-550-2814
Practice Address - Street 1:6839 HIGHWAY 6 N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-1315
Practice Address - Country:US
Practice Address - Phone:281-859-9136
Practice Address - Fax:281-550-2814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7561TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX336206YYFDMedicare PIN
TX336208YYFDMedicare PIN