Healthcare Provider Details

I. General information

NPI: 1467978106
Provider Name (Legal Business Name): H&M REFRACTION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1765 N TOWN EAST BLVD
MESQUITE TX
75150-4172
US

IV. Provider business mailing address

3801 S CONGRESS AVE
PALM SPRINGS FL
33461-4140
US

V. Phone/Fax

Practice location:
  • Phone: 469-804-4333
  • Fax:
Mailing address:
  • Phone: 561-275-2020
  • Fax: 561-275-2030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JACKIE BENNETT
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 561-433-6009