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General NPI Number Information
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NPI Number | 1740792738
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Entity Type | Organization
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Legal Business Name | CLEAR VISION EXPRESS LAREDO 3 LLC
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Dates
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Enumeration Date | 10/30/2017
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Last Update Date | 10/30/2017
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Provider Practice Location Address
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Address Line | 9902 MCPHERSON RD STE 14&15
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City | LAREDO
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State | TX
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Zip | 78045-6545
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Country | US
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Telephone | 956-795-8310
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Fax | 956-795-8313
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Provider Business Mailing Address
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Address Line | 5401 MCPHERSON RD STE 13
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City | LAREDO
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State | TX
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Zip | 78041-6834
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Country | US
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Telephone | 956-704-5014
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MICHAEL A HOCHMAN
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Credential | MD
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Telephone | 956-795-8310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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