MEDICARE: I & N OPTICAL, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BLOCK VISION	OTHER	TX	919511

General Provider Information

NPI Number	:	1033217195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	I & N OPTICAL, INC.

Provider Business Mailing Address
First Line	:	6813 GREEN OAKS RD
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76116-1713
Country	:	US
Telephone Number	:	817-731-7434
Fax Number	:	817-738-2043

Provider Business Practice Location Address
First Line	:	6813 GREEN OAKS RD
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76116-1713
Country	:	US
Telephone Number	:	817-731-7434
Fax Number	:	817-738-2043

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ISAAK GREENSTEIN
Credential	:
Telephone Number	:	817-370-1811

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/22/2020

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Directions to “I & N OPTICAL, INC. ” Practice Location

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