| NPI | 1497751838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MO LUCIA LIVERMORE Practice Administrator 512-279-3004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2025-08-28 |