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General NPI Number Information
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NPI Number | 1568590081
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Entity Type | Organization
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Legal Business Name | OPTICAL PRESCRIPTION SERVICE, INC.
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 401 W HIGHLAND BLVD
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City | SAN ANGELO
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State | TX
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Zip | 76903-7314
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Country | US
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Telephone | 325-655-9998
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Fax | 325-653-1350
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Provider Business Mailing Address
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Address Line | 401 W HIGHLAND BLVD
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City | SAN ANGELO
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State | TX
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Zip | 76903-7314
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Country | US
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Telephone | 325-655-9998
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Fax | 325-653-1350
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. WILFRED DEE SPARKS JR.
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Credential | CERTIFIED OPTICIAN
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Telephone | 325-655-9998
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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 | 0
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License Number State | TX
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