MEDICARE: STYLED EYES

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
1	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1578456372
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STYLED EYES

Provider Business Mailing Address
First Line	:	N82W15340 APPLETON AVE
Second Line	:
City	:	MENOMONEE FALLS
State	:	WI
Zip	:	53051-3777
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	N82W15340 APPLETON AVE
Second Line	:
City	:	MENOMONEE FALLS
State	:	WI
Zip	:	53051-3777
Country	:	US
Telephone Number	:	262-255-5752
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DEBRA GALLE
Credential	:
Telephone Number	:	262-255-5754

Provider Enumeration Date	:	05/30/2025
Last Update Date	:	05/30/2025

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Directions to “STYLED EYES ” Practice Location

Language	Start Address	Practice Location

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