Healthcare Provider Details

I. General information

NPI: 1619551272
Provider Name (Legal Business Name): OCULUS EYEWEAR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2430 S IH 35 STE 110
SAN MARCOS TX
78666-5921
US

IV. Provider business mailing address

2430 S IH 35 STE 110
SAN MARCOS TX
78666-5921
US

V. Phone/Fax

Practice location:
  • Phone: 512-396-1500
  • Fax:
Mailing address:
  • Phone: 512-396-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: LEAH JOHNSON
Title or Position: MANAGER
Credential:
Phone: 512-396-1500