| NPI | 1912230780 |
|---|---|
| Doing Business As | JACKSON AND LUJAN EYECARE CENTER |
| Entity Type | Organization |
| Authorized Contact | SHAWNA WIETZ FOX Co Owner 210-737-1926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 5505TG) |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2009-09-11 |