Provider Demographics
NPI:1952415390
Name:PASS, HULON HOUSTON (OD)
Entity Type:Individual
Prefix:DR
First Name:HULON
Middle Name:HOUSTON
Last Name:PASS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1568
Mailing Address - Street 2:
Mailing Address - City:FORT STOCKTON
Mailing Address - State:TX
Mailing Address - Zip Code:79735-1568
Mailing Address - Country:US
Mailing Address - Phone:432-336-3662
Mailing Address - Fax:432-336-7806
Practice Address - Street 1:605 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FORT STOCKTON
Practice Address - State:TX
Practice Address - Zip Code:79735-5625
Practice Address - Country:US
Practice Address - Phone:432-336-3662
Practice Address - Fax:432-336-7806
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3081TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX410007044OtherRAILROAD MEDICARE
TX093195802Medicaid
TXT15188Medicare UPIN
TX00E33DMedicare PIN
TX0200730001Medicare NSC