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General NPI Number Information
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NPI Number | 1467620245
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Entity Type | Organization
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Legal Business Name | GLENN'S OPTIQUES #2 INC.
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Dates
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Enumeration Date | 02/14/2008
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Last Update Date | 02/27/2008
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Provider Practice Location Address
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Address Line | 120 W MAIN ST STE 210
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City | MESQUITE
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State | TX
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Zip | 75149-4224
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Country | US
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Telephone | 972-285-9896
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Fax | 972-285-1005
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Provider Business Mailing Address
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Address Line | 120 W MAIN ST STE 210
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City | MESQUITE
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State | TX
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Zip | 75149-4224
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Country | US
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Telephone | 972-285-9896
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Fax | 972-285-1005
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Authorized Official
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Title or Position | MANAGER
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Name | MS. HELEN MCKINNEY
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Credential | OPTICIAN
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Telephone | 214-957-1934
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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 | #223
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License Number State | TX
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