Organization
COASTAL EYE ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELLY FERREE (EXECUTIVE ADMINISTRATOR)
(281) 488-7213
Entity
Organization
Contact information
Practice address
11550 FUQUA ST, SUITE 250, HOUSTON, TX 77034-4599
(281) 488-7213
(281) 669-3602
Mailing address
555 E MEDICAL CENTER BLVD STE 101, WEBSTER, TX 77598-4367
(281) 488-7213
(281) 488-1387
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
345484501
—
TX
01
—
45D2057002
CLIA
TX
Enumeration date
10/22/2007
Last updated
02/02/2016
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