Healthcare Provider Details

I. General information

NPI: 1902096126
Provider Name (Legal Business Name): ESSILOR LABORATORIES OF AMERICA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 08/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 W MCNAB RD
POMPANO BEACH FL
33069-4804
US

IV. Provider business mailing address

13515 N STEMMONS FWY
DALLAS TX
75234-5765
US

V. Phone/Fax

Practice location:
  • Phone: 800-327-4118
  • Fax:
Mailing address:
  • Phone: 800-843-3937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: REAL GOULET
Title or Position: SR. VICE PRESIDENT, NATIONAL LABS
Credential:
Phone: 214-496-4105