| |
1013 South Wells Street, Edna, TX 77957-4098 | |
(361) 782-5241 | |
(361) 782-7495 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 1013 South Wells Street, Edna, Texas |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215950308 | NPI | - | NPPES |
0072KD | Other | TX | BLUE CROSS BLUE SHIELD |
158559801 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
21502 Merchants Way Ste A, Katy, TX 77449-2515 Ph: (281) 944-2232 | 1013 South Wells Street, Edna, TX 77957-4098 Ph: (361) 782-5241 |