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Organization
SMGS PC
Active
Organization
SMGS PC
Active
Other names
Bay Colony EyeCare
Organization subpart
No
Provider details
NPI number
Authorized official
SERITA M GARDNER OD (PRESIDENT)
(281) 309-9700
Entity
Organization
Contact information
Practice address
2945 GULF FWY S STE C, LEAGUE CITY, TX 77573-6771
(281) 309-9700
(281) 309-9720
Mailing address
2945 GULF FWY S STE C, LEAGUE CITY, TX 77573-6771
(281) 309-9700
(281) 309-9720
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4258T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103821
—
TX
01
—
81302Q
BCBS
TX
Enumeration date
03/27/2008
Last updated
03/27/2008
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