| NPI | 1831841766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA C KOPLOS Sole Member 915-490-9711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WL0500X Optometrist, Low Vision Rehabilitation |
| Additional Taxonomies | 152W00000X Optometrist |
| 152WP0200X Optometrist, Pediatrics | |
| 152WS0006X Optometrist, Sports Vision | |
| 152WV0400X Optometrist, Vision Therapy | |
| 152WX0102X Optometrist, Occupational Vision | |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2022-10-04 |