Provider Demographics
NPI:1427325893
Name:HOME EYE CARE ASSOCIATES
Entity type:Organization
Organization Name:HOME EYE CARE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:832-671-1265
Mailing Address - Street 1:2818 WHISPERING FERN CT
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-2227
Mailing Address - Country:US
Mailing Address - Phone:832-671-1265
Mailing Address - Fax:888-818-2152
Practice Address - Street 1:2818 WHISPERING FERN CT
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77345-2227
Practice Address - Country:US
Practice Address - Phone:832-671-1265
Practice Address - Fax:888-818-2152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-29
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6106TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83282QOtherBCBSTX
TX288690501Medicaid
TXDT0393Medicare PIN
TX288690501Medicaid