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NPI 1679496293

NPI 1679496293 : EYEMART EXPRESS LLC : ROSENBERG, TX

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General NPI Number Information
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    NPI Number           |    1679496293
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    Entity Type          |    Organization 
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    Legal Business Name  |    EYEMART EXPRESS LLC 
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Dates
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    Enumeration Date     |    07/31/2026
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    Last Update Date     |    07/31/2026
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Provider Practice Location Address
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    Address Line         |    3415 FM 762 RD STE 100A 
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    City                 |    ROSENBERG
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    State                |    TX
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    Zip                  |    77469-5580
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    Country              |    US
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    Telephone            |    832-278-4208
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    Fax                  |    832-278-4210
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Provider Business Mailing Address
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    Address Line         |    3415 FM 762 RD STE 100A 
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    City                 |    ROSENBERG
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    State                |    TX
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    Zip                  |    77469-5580
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    Country              |    US
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    Telephone            |    832-278-4208
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    Fax                  |    832-278-4210
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Authorized Official
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    Title or Position    |    DIRECTOR OF CREDENTIALING
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    Name                 |     KIM  CARUSO 
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    Credential           |    
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    Telephone            |    646-660-1993
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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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