Organization
DR. SANDRA E. COLLAZO, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA COLLAZO O.D. (PRESIDENT)
(713) 827-9800
Entity
Organization
Contact information
Practice address
10488 KATY FWY STE A, HOUSTON, TX 77043-5106
(713) 827-9800
Mailing address
10488 KATY FWY STE A, HOUSTON, TX 77043-5106
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5109TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101690903
—
TX
01
—
16849
COAST TO COAST VISION
—
01
—
918534
AMERIGROUP
—
Enumeration date
11/12/2011
Last updated
11/12/2011
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