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General NPI Number Information
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NPI Number | 1891839254
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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 | 02/19/2007
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Last Update Date | 01/31/2008
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Provider Practice Location Address
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Address Line | 501 N MAIN ST SPACE #36A-ARROWHEAD MALL
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City | MUSKOGEE
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State | OK
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Zip | 74401-6348
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Country | US
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Telephone | 918-686-7788
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Fax | 918-686-5566
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Provider Business Mailing Address
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Address Line | 2110 HUTTON DR SUITE 100
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City | CARROLLTON
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State | TX
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Zip | 75006-6800
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Country | US
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Telephone | 972-488-2002
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Fax | 972-488-8563
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | MARY JO SAMUELSON
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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