MEDICARE: LAYTON OPTICAL COMPANY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	TX
2	332BC3200X	Customized Equipment (DME)	TX
3	332H00000X	Eyewear Supplier	TX

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
2	500634	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1912126442
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAYTON OPTICAL COMPANY

Provider Business Mailing Address
First Line	:	2617 MORGAN AVE
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78405-1808
Country	:	US
Telephone Number	:	361-883-2216
Fax Number	:

Provider Business Practice Location Address
First Line	:	2617 MORGAN AVE
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78405-1808
Country	:	US
Telephone Number	:	361-883-2216
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JAMES LAYTON JR.
Credential	:
Telephone Number	:	361-883-2216

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	10/17/2012

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Directions to “LAYTON OPTICAL COMPANY ” Practice Location

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