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General NPI Number Information
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NPI Number | 1013933910
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Entity Type | Organization
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Legal Business Name | SPECTERA
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | UNITED OPTICAL 1127 15TH STREET, NW
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City | WASHINGTON
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State | DC
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Zip | 20005
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Country | US
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Telephone | 202-331-0513
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Fax | 202-331-3327
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Provider Business Mailing Address
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Address Line | 2811 LORD BALTIMORE DR.
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City | BALTIMORE
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State | MD
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Zip | 21244
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Country | US
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Telephone | 443-316-2101
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Fax | 410-265-6068
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | THOMAS A HEETER
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Credential |
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Telephone | 443-316-2061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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