Organization
EYE IMPACT PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY NGUYEN O.D. (OPTOMETRIST)
(832) 319-7732
Entity
Organization
Contact information
Practice address
5601 WASHINGTON AVE, HOUSTON, TX 77007-5134
(832) 319-7732
(832) 319-7737
Mailing address
5601 WASHINGTON AVE, HOUSTON, TX 77007-5134
(832) 319-7732
(832) 319-7737
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5813-T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11616015
CAQH
TX
Enumeration date
10/04/2013
Last updated
10/04/2013
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