| NPI | 1720241029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMERY MACK ANDERSON O PT Ician 409-833-3261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Licence: TX DR1478) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2008-07-21 |