| NPI | 1588849988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEL C GERDES Secretary 254-776-3423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: TX 2467TG) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 2467TG) |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2008-02-25 |