| NPI | 1740200518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYA PATHAPATI Owner 806-358-3594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2022-03-27 |