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NPI Code Detail

MEDICARE: EYEMART EXPRESS LTD

MEDICARE: EYEMART EXPRESS LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1093805004
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYEMART EXPRESS LTD
Provider Business Mailing Address
First Line : 2110 HUTTON DR
Second Line : #100
City : CARROLLTON
State : TX
Zip : 75006
Country : US
Telephone Number : 972-488-2002
Fax Number : 972-488-8563
Provider Business Practice Location Address
First Line : 4415 AMBASSADOR CAFFERY PKWY
Second Line : STE 100
City : LAFAYETTE
State : LA
Zip : 70508-6705
Country : US
Telephone Number : 337-406-0620
Fax Number : 337-406-0667
Authorized Official
Title or Position : CAO
Name : MARY JO SAMUELSON
Credential :
Telephone Number : 972-488-2002
Provider Enumeration Date : 10/13/2006
Last Update Date : 08/22/2020

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Directions to “EYEMART EXPRESS LTD ” Practice Location

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