| NPI | 1720468630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK F MICHELETTI Executive Director 281-348-4615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| 332H00000X Eyewear Supplier | |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2023-03-31 |