Provider Demographics
NPI:1386980084
Name:SCRC GROUP LTD LLP
Entity type:Organization
Organization Name:SCRC GROUP LTD LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:W
Authorized Official - Last Name:CHARRIER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:713-349-0224
Mailing Address - Street 1:5177 RICHMOND AVE
Mailing Address - Street 2:SUITE 780
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-6707
Mailing Address - Country:US
Mailing Address - Phone:713-349-0224
Mailing Address - Fax:713-349-9834
Practice Address - Street 1:5177 RICHMOND AVE
Practice Address - Street 2:SUITE 780
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-6707
Practice Address - Country:US
Practice Address - Phone:713-349-0224
Practice Address - Fax:713-349-9834
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SCRC MANAGEMENT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-27
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDU1280OtherRAILROAD MEDICARE PTAN
TX284513Medicare PIN