Healthcare Provider Details

I. General information

NPI: 1922675529
Provider Name (Legal Business Name): SIGHT AND SUN EYEWORKS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2021
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13141 N DALE MABRY HWY STE D&E
TAMPA FL
33618-2443
US

IV. Provider business mailing address

PO BOX 207151
DALLAS TX
75320-7151
US

V. Phone/Fax

Practice location:
  • Phone: 813-264-2769
  • Fax: 813-264-8022
Mailing address:
  • Phone: 636-200-4393
  • Fax: 636-527-0766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: JAMES WACHTER
Title or Position: CMO
Credential:
Phone: 636-200-4393