1811344674 NPI number — RAYFORD EYE ASSOCIATES, PLLC

Table of content: (NPI 1811344674)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811344674 NPI number — RAYFORD EYE ASSOCIATES, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAYFORD EYE ASSOCIATES, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811344674
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6046 FM 2920 RD # 311
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRING
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77379-2542
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-719-9926
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2833 RILEY FUZZEL RD.
Provider Second Line Business Practice Location Address:
#300
Provider Business Practice Location Address City Name:
SPRING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77386
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-719-9926
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/20/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MEHTA
Authorized Official First Name:
HIRAL
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING MEMBER
Authorized Official Telephone Number:
281-719-9926

Provider Taxonomy Codes

  • Taxonomy code: 152WC0802X , with the licence number:  7714TG , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WL0500X , with the licence number: 7714TG , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WP0200X , with the licence number: 7714TG , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WS0006X , with the licence number: 7714TG , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 7714TG , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)