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General NPI Number Information
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NPI Number | 1720241029
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Entity Type | Organization
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Legal Business Name | SMITH-HAYES OPTICAL SERVICE, INC
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Dates
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Enumeration Date | 07/07/2008
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 229 DOWLEN RD SUITE 4A
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City | BEAUMONT
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State | TX
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Zip | 77706-5919
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Country | US
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Telephone | 409-833-3261
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Fax | 409-866-6849
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Provider Business Mailing Address
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Address Line | 229 DOWLEN RD SUITE 4A
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City | BEAUMONT
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State | TX
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Zip | 77706-5919
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Country | US
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Telephone | 409-833-3261
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Fax | 409-866-6849
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Authorized Official
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Title or Position | OPTICIAN
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Name | MR. EMERY MACK ANDERSON
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Credential |
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Telephone | 409-833-3261
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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 | DR1478
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License Number State | TX
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