Organization
CHAMPIONS EYECARE PC
Active
Other names
TEXAS STATE OPTICAL OF CHAMPIONS VILLAGE
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE MALTZ O.D. (PRESIDENT)
(281) 440-5887
Entity
Organization
Contact information
Practice address
5774 FM 1960 RD W, HOUSTON, TX 77069-4204
(281) 440-5887
(281) 440-0368
Mailing address
5774 FM 1960 RD W, HOUSTON, TX 77069-4204
(281) 440-5887
(281) 440-0368
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2671T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DP3464
RAILROAD MEDICARE PTAN
TX
01
—
P00749723
RAILROAD MEDICARE
TX
Enumeration date
04/18/2007
Last updated
06/21/2018
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