NPI | 1104001643 |
---|---|
Entity Type | Organization |
Authorized Contact | GABRIEL AVILA O PT Ometrist/Owner 325-692-9596 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: TX TX6293TG) |
Enumeration Date | 2008-01-03 |
Last Update Date | 2008-02-15 |