Organization
EAST TEXAS EYE CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. K RAY SHRUM MD (PRESIDENT)
(281) 659-2020
Entity
Organization
Contact information
Practice address
901 E HOUSTON ST, STE B, CLEVELAND, TX 77327-4602
(281) 659-2020
(281) 659-2030
Mailing address
18700 W LAKE HOUSTON PKWY, STE B101, HUMBLE, TX 77346-3349
(281) 812-4000
(281) 812-3331
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
02830TG
TX
207W00000X
Ophthalmology Physician
Primary
L2649
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0084GS
BLUE CROSS BLUE SHIELD
TX
05
—
145198102
—
TX
05
—
145198103
—
TX
01
—
180044544
MEDICARE RAILROAD
—
01
—
21210202328
BEECH STREET
—
01
—
4119904
CIGNA
—
01
—
5248990
FIRST HEALTH
—
01
—
7114117
AETNA
—
01
—
918304
BLOCK VISION
—
01
—
975250
ONE HEALTH PLAN
—
01
—
DE8958
MEDICARE RAILROAD
TX
Enumeration date
07/11/2006
Last updated
05/05/2015
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