Organization
BERKELEY EYE INSTITUTE, PLLC
Active
Other names
Berkeley Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
MARK F MICHELETTI (EXECUTIVE DIRECTOR)
(281) 348-4615
Entity
Organization
Contact information
Practice address
5419 FM 1960 RD W, SUITE C, HOUSTON, TX 77069-4305
(281) 894-2020
(281) 537-7617
Mailing address
5419 FM 1960 RD W, SUITE C, HOUSTON, TX 77069-4305
(281) 894-2020
(281) 537-7617
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0072KD
BLUE CROSS BLUE SHIELD
TX
05
—
158574701
—
TX
01
—
4894760005
PALMETTO GBA
TX
Enumeration date
07/26/2006
Last updated
03/31/2023
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