| NPI | 1174842405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETTLY JOEL TEAGUE Owner/Md 325-690-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2010-06-14 |