Provider Demographics
NPI:1063694800
Name:GOLD OPTICAL INC.
Entity type:Organization
Organization Name:GOLD OPTICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:713-644-2375
Mailing Address - Street 1:711 SHOTWELL ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77020-4813
Mailing Address - Country:US
Mailing Address - Phone:713-644-2375
Mailing Address - Fax:713-673-6900
Practice Address - Street 1:6328 TELEPHONE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-5410
Practice Address - Country:US
Practice Address - Phone:713-644-2375
Practice Address - Fax:713-673-6900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1297340001Medicare NSC