Provider Demographics
NPI:1013015262
Name:I & N OPTICAL, INC
Entity Type:Organization
Organization Name:I & N OPTICAL, INC
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAK
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-370-1811
Mailing Address - Street 1:800 E SEMINARY DR
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76115-2732
Mailing Address - Country:US
Mailing Address - Phone:817-923-2096
Mailing Address - Fax:817-926-5810
Practice Address - Street 1:800 E SEMINARY DR
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76115-2732
Practice Address - Country:US
Practice Address - Phone:817-923-2096
Practice Address - Fax:817-926-5810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX01976001Medicaid
TX23724OtherOPTICARE
TX919511OtherBLOCK VISION