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General NPI Number Information
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NPI Number | 1821139643
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Entity Type | Organization
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Legal Business Name | SUPERIOR VISION LLC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 09/12/2008
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Provider Practice Location Address
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Address Line | 1301 W GLADE RD STE 196
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City | EULESS
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State | TX
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Zip | 76039-5419
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Country | US
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Telephone | 817-685-7200
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Fax | 817-685-7211
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Provider Business Mailing Address
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Address Line | 1301 W GLADE RD STE 196
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City | EULESS
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State | TX
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Zip | 76039-5419
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Country | US
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Telephone | 817-685-7200
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Fax | 817-685-7211
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. SVETLANA RONIN
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Credential |
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Telephone | 817-685-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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