Organization
BERKELEY EYE INSTITUTE, PLLC
Active
Other names
Berkeley Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK F MICHELETTI (EXECUTIVE DIRECTOR)
(281) 348-4615
Entity
Organization
Contact information
Practice address
3100 WESLAYAN ST, STE 400, HOUSTON, TX 77027-5752
(713) 526-1600
(713) 526-6520
Mailing address
21502 MERCHANTS WAY STE A, KATY, TX 77449-2515
(281) 944-2232
(281) 944-2290
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
BCBS
TX
05
—
158559801
—
TX
05
—
158574701
—
TX
05
—
191166101
—
TX
Enumeration date
06/21/2005
Last updated
03/28/2023
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