| NPI | 1104031012 |
|---|---|
| Doing Business As | BEAUMONT OPTICAL SHOP |
| Entity Type | Organization |
| Authorized Contact | LEE ANN ODOM President Shared Services 947-522-3326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2021-10-01 |