Ketcham, Tonya

Ketcham, Tonya is an individual health care provider with primary practice located at 4401 Martin Luther King Blvd. , Houston TX 77204-2020. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Ketcham, Tonya can be contacted via phone (713) 743-2020.

Contact Information

Primary practice address
4401 Martin Luther King Blvd. Houston TX 77204-2020
Phone: (713) 743-2020
Fax: (713) 743-0963
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 6659T Texas
Eye and Vision Services Providers / Optometrist 152W00000X 6659 Texas

Profile Details

NPI number 1902809338
LBN Legal business name Ketcham, Tonya
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated May 12th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902809338 NPPES
Texas MEDICAID 175282601

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