MEDICARE: STEIN 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	332H00000X	Eyewear Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548341597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEIN OPTICAL INC

Provider Business Mailing Address
First Line	:	PO BOX 846309
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-6309
Country	:	US
Telephone Number	:	210-524-6663
Fax Number	:	210-524-6587

Provider Business Practice Location Address
First Line	:	5300 S 76TH ST
Second Line	:
City	:	GREENDALE
State	:	WI
Zip	:	53129-1102
Country	:	US
Telephone Number	:	414-421-6450
Fax Number	:	414-421-0261

Authorized Official
Title or Position	:	OFFICER
Name	:	DOUG NEWCOM
Credential	:
Telephone Number	:	210-524-6700

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	08/21/2008

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Directions to “STEIN OPTICAL INC ” Practice Location

Language	Start Address	Practice Location

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