| NPI | 1629241617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY DALE GUNNELL O PT Ometrist 940-696-0296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: TX 2496TG) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2023-03-07 |