Provider Demographics
NPI:1063624112
Name:STEPHEN H MEANS O D & ASSOCIATES
Entity type:Organization
Organization Name:STEPHEN H MEANS O D & ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEANS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:936-291-8282
Mailing Address - Street 1:109 MEDICAL PARK LN
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-4977
Mailing Address - Country:US
Mailing Address - Phone:936-291-8282
Mailing Address - Fax:936-291-9863
Practice Address - Street 1:109 MEDICAL PARK LN
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340
Practice Address - Country:US
Practice Address - Phone:936-291-8282
Practice Address - Fax:936-291-9863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4518TX332H00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019538001Medicaid
TX4385230001Medicare PIN
TX4385230001Medicare NSC
TXU20718Medicare UPIN