MEDICARE: A VISION OPTICAL

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

General Provider Information

NPI Number	:	1942642434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A VISION OPTICAL

Provider Business Mailing Address
First Line	:	30919 FM 1847
Second Line	:
City	:	SAN BENITO
State	:	TX
Zip	:	78586-9706
Country	:	US
Telephone Number	:	956-579-8028
Fax Number	:	956-246-4255

Provider Business Practice Location Address
First Line	:	889 S SAM HOUSTON BLVD
Second Line	:
City	:	SAN BENITO
State	:	TX
Zip	:	78586-3062
Country	:	US
Telephone Number	:	956-579-8028
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. ESTEFANA CRUZ SANCHEZ
Credential	:
Telephone Number	:	956-579-8028

Provider Enumeration Date	:	07/24/2013
Last Update Date	:	07/24/2013

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Directions to “A VISION OPTICAL ” Practice Location

Language	Start Address	Practice Location

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