MEDICARE: OCULUS EYEWEAR, LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1619551272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCULUS EYEWEAR, LLC

Provider Business Mailing Address
First Line	:	2430 S IH 35 STE 110
Second Line	:
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-5921
Country	:	US
Telephone Number	:	512-396-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	2430 S IH 35 STE 110
Second Line	:
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-5921
Country	:	US
Telephone Number	:	512-396-1500
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	LEAH JOHNSON
Credential	:
Telephone Number	:	512-396-1500

Provider Enumeration Date	:	05/10/2021
Last Update Date	:	08/29/2022

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