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Organization
PREMIUM EYECARE PLLC
Active
Organization
PREMIUM EYECARE PLLC
Active
Other names
Premium Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL T UKWADE (THERAPEUTIC OPTOMETRIST)
(281) 488-4774
Entity
Organization
Contact information
Practice address
2402 BAY AREA BLVD, STE. F, HOUSTON, TX 77058-1565
(281) 488-4774
(281) 488-4775
Mailing address
2402 BAY AREA BLVD, STE. F, HOUSTON, TX 77058-1565
(281) 488-4774
(281) 488-4775
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0018FE
BLUECROSS BLUESHIELD
—
01
—
26172
SPECTERA
—
01
—
54199
DAVIS VISION
—
01
—
TX4037
EYEMED
—
Enumeration date
06/07/2007
Last updated
08/22/2020
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