| NPI | 1821089640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDDIE M MAYES President 270-754-4515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2005-11-01 |
| Last Update Date | 2010-06-25 |