Provider Demographics
NPI:1689655672
Name:UNIVERSITY EYE ASSOCIATES
Entity type:Organization
Organization Name:UNIVERSITY EYE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:VON
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-486-9435
Mailing Address - Street 1:6400 FANNIN ST FL 18
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1511
Mailing Address - Country:US
Mailing Address - Phone:713-559-5200
Mailing Address - Fax:713-559-5292
Practice Address - Street 1:6400 FANNIN ST FL 18
Practice Address - Street 2:SUITE 1800
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1511
Practice Address - Country:US
Practice Address - Phone:713-559-5200
Practice Address - Fax:713-559-5292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00J79XMedicare ID - Type UnspecifiedGROUP MEDICARE NUMBER