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General NPI Number Information
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NPI Number | 1770016982
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Entity Type | Organization
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Legal Business Name | CLEAR VISION EXPRESS TUCSON,LLC
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Dates
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Enumeration Date | 04/05/2017
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Last Update Date | 04/05/2017
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Provider Practice Location Address
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Address Line | 5313 MCPHERSON RD
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City | LAREDO
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State | TX
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Zip | 78041-6832
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Country | US
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Telephone | 956-795-8310
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Fax |
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Provider Business Mailing Address
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Address Line | 6691 N THORNYDALE RD
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City | TUCSON
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State | AZ
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Zip | 85741-2737
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Country | US
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Telephone | 956-795-8310
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/MANAGER
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Name | DR. MICHAEL AVERY 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 | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | TXK7557
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License Number State | TX
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