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Individual

DAN G TOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1520 W BAY AREA BLVD, SUITE 1, FRIENDSWOOD, TX 77546-2600
(832) 934-1166
(832) 934-1161
Mailing address
1520 W BAY AREA BLVD, SUITE 1, FRIENDSWOOD, TX 77546-2600
(832) 934-1166
(832) 934-1161

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3230TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
093614803
TX
01
3230TG
TEXAS OPTOMETRY LICENSE
TX
Enumeration date
02/20/2007
Last updated
08/08/2013
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