| NPI | 1972941193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIBEL GOMEZ-LOPEZ President 939-249-3417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
| 332H00000X Eyewear Supplier (Equipment, not the service) | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2013-06-12 |