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General NPI Number Information
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NPI Number | 1730940164
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Entity Type | Organization
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Legal Business Name | XPRESS OPTICAL SERVICES LLC
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | CARR 155 KM 66 H 0 BO ALGARROBO
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-356-9808
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Fax |
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Provider Business Mailing Address
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Address Line | PMB 138 PO BOX 144035
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City | ARECIBO
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State | PR
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Zip | 00614
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JUAN C RUIZ REYES
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Credential |
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Telephone | 787-356-9808
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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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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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