| NPI | 1124049010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL PRO Optican 361-994-0776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: TX 42144) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2008-07-21 |