| NPI | 1043391105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY REYNOLDS Officer 210-524-6515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2015-01-08 |