BRAZOSPORT EYE FACILITY, INC.
Ambulatory Health at Parking Way St, Richwood, TX

License number
Texas 157
Category
Ambulatory Health
Type
Ambulatory Surgical
Owner
Name: DONNA GRADY
Title: ADMINISTRATOR
Phone: (979) 297-2961
Address
Address
103 Parking Way St, Richwood, TX 77566
National Provider ID: 1396870028
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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BRAZOSPORT EYE FACILITY, INC

Richwood, TX

Registration:
May 3, 1984
Addresses:
Grady 103 Parking Way, Lake Jackson, TX 77566 (Mailing)
103 Parking Way St, Richwood, TX 77566
State ID:
0070331200
Business type:
Domestic For-Profit Corporation
President, Director:
Frank J Grady (President, Director), PO Box 369, Lake Jackson, TX 77566
TIN:
17601064490

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