Healthcare Provider Details

I. General information

NPI: 1124958376
Provider Name (Legal Business Name): EYEMART EXPRESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8481 WEST STATE HIGHWAY 29 SUITE 140
LEANDER TX
78628
US

IV. Provider business mailing address

8481 WEST STATE HIGHWAY 29 SUITE 140
LEANDER TX
78628
US

V. Phone/Fax

Practice location:
  • Phone: 737-379-2288
  • Fax: 737-379-2380
Mailing address:
  • Phone: 737-379-2288
  • Fax: 737-379-2380

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KIM CARUSO
Title or Position: DIRECTOR OF CREDENTIALING
Credential:
Phone: 646-660-1993