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General NPI Number Information
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NPI Number | 1962754242
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Entity Type | Organization
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Legal Business Name | VISUAL EYES
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Dates
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Enumeration Date | 10/10/2012
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Last Update Date | 10/10/2012
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Provider Practice Location Address
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Address Line | 117 SOUTHPOINT LOOP SUITE 200
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City | LIVINGSTON
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State | TX
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Zip | 77351-8899
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Country | US
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Telephone | 936-327-9747
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Fax | 936-327-9747
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Provider Business Mailing Address
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Address Line | 117 SOUTHPOINT LOOP SUITE 200
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City | LIVINGSTON
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State | TX
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Zip | 77351-8899
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Country | US
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Telephone | 936-327-9747
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Fax | 936-327-9747
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. CLESTEL RIFFE
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Credential | ABOC
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Telephone | 936-327-9747
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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 | TX
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