Provider Demographics
NPI:1306281845
Name:EVERETT HYMAN, OD PC
Entity type:Organization
Organization Name:EVERETT HYMAN, OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EVERETT
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:HYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:281-493-4455
Mailing Address - Street 1:14441 MEMORIAL DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-6744
Mailing Address - Country:US
Mailing Address - Phone:281-493-4455
Mailing Address - Fax:
Practice Address - Street 1:14441 MEMORIAL DR
Practice Address - Street 2:SUITE 7
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-6744
Practice Address - Country:US
Practice Address - Phone:281-493-4455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2237TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13987Medicare UPIN