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General NPI Number Information
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NPI Number | 1235564592
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Entity Type | Organization
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Legal Business Name | HORIZON FAMILY OPTICAL
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Dates
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Enumeration Date | 09/05/2013
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Last Update Date | 09/05/2013
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Provider Practice Location Address
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Address Line | 125 N KENAZO AVE STE F
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City | HORIZON CITY
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State | TX
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Zip | 79928-5401
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Country | US
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Telephone | 915-852-2861
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Fax | 915-852-2861
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Provider Business Mailing Address
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Address Line | 125 N KENAZO AVE STE F
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City | HORIZON CITY
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State | TX
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Zip | 79928-5401
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Country | US
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Telephone | 915-852-2861
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Fax | 915-852-2861
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID EDWARD STOUT
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Credential | OPTICIAN
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Telephone | 915-852-2861
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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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