Provider Demographics
NPI:1265613897
Name:MELISSA M. SOMMERS, OD, PC
Entity type:Organization
Organization Name:MELISSA M. SOMMERS, OD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SOMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:281-332-0698
Mailing Address - Street 1:100 E NASA STE 70
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-5300
Mailing Address - Country:US
Mailing Address - Phone:281-332-0698
Mailing Address - Fax:
Practice Address - Street 1:100 E NASA STE 70
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-5300
Practice Address - Country:US
Practice Address - Phone:281-332-0698
Practice Address - Fax:281-332-6689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX2546152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX IDENTIFICATION NUMBER
TX00904NMedicare PIN
TXT90851Medicare UPIN