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General NPI Number Information
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NPI Number | 1831431691
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Entity Type | Organization
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Legal Business Name | EYEMART EXPRESS LTD
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Dates
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Enumeration Date | 03/20/2013
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Last Update Date | 03/20/2013
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Provider Practice Location Address
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Address Line | 2900 W. LOOP 250 NORTH, SUITE 165
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City | MIDLAND
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State | TX
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Zip | 79705
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Country | US
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Telephone | 432-897-1107
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Fax | 432-897-2473
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Provider Business Mailing Address
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Address Line | 2900 W. LOOP 250 NORTH, SUITE 165
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City | MIDLAND
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State | TX
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Zip | 79705
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Country | US
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Telephone | 432-897-1107
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Fax | 432-897-2473
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Authorized Official
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Title or Position | DIRECTOR OF MANAGED CARE
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Name | KAREN PITTMAN
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Credential |
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Telephone | 972-488-2002
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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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