Provider Demographics
NPI:1992413561
Name:VIP EYECARE LLC
Entity type:Organization
Organization Name:VIP EYECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST, OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIETT
Authorized Official - Middle Name:
Authorized Official - Last Name:LAM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:713-423-9532
Mailing Address - Street 1:13709 STATE HIGHWAY 249
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77086-2705
Mailing Address - Country:US
Mailing Address - Phone:346-490-3319
Mailing Address - Fax:346-456-4010
Practice Address - Street 1:13709 STATE HIGHWAY 249
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77086-2705
Practice Address - Country:US
Practice Address - Phone:346-490-3319
Practice Address - Fax:346-456-4010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186674101Medicaid