Provider Demographics
NPI:1992922777
Name:SURGICAL EYE ASSOCIATES, P.A.
Entity type:Organization
Organization Name:SURGICAL EYE ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:SUTHERLAND
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-537-0100
Mailing Address - Street 1:1631 NORTH LOOP WEST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008
Mailing Address - Country:US
Mailing Address - Phone:713-869-6400
Mailing Address - Fax:713-802-0691
Practice Address - Street 1:829 PEAKWOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2907
Practice Address - Country:US
Practice Address - Phone:281-537-0100
Practice Address - Fax:281-537-5093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05253T152W00000X
TX03629TG152W00000X
TXF0436207W00000X
TXG2587207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB20947Medicare UPIN
TXC15099Medicare UPIN
TXU63893Medicare UPIN
TXT96235Medicare UPIN
TX8A6253Medicare ID - Type UnspecifiedKATHLEEN F. ARCHER, M.D.
TX8D7053Medicare ID - Type UnspecifiedDEBORAH A. EVANS, O.D.
TX8A2093Medicare ID - Type UnspecifiedGINA E. KIM, O.D.
TX87V801Medicare ID - Type UnspecifiedPETER S. DAWSON, M.D.