Healthcare Provider Details
I. General information
NPI: 1639251960
Provider Name (Legal Business Name): HOUR EYES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/19/2006
Last Update Date: 08/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1003 FAIRLAWN AVENUE SUITE 24A
LAUREL MD
20707
US
IV. Provider business mailing address
PO BOX 842375
DALLAS TX
75284-2375
US
V. Phone/Fax
- Phone: 301-776-1818
- Fax: 301-776-1967
- Phone: 210-524-6663
- Fax: 210-524-6587
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332H00000X |
| Taxonomy | Eyewear Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAN
POTH
Title or Position: OWNER
Credential: O.D.
Phone: 703-288-1978