Provider Demographics
NPI:1083047856
Name:CENTRAL EXPRESSWAY OPTICAL INC.
Entity Type:Organization
Organization Name:CENTRAL EXPRESSWAY OPTICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:KINSELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-373-8100
Mailing Address - Street 1:10910 N CENTRAL EXPY
Mailing Address - Street 2:SUITE #700
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-2500
Mailing Address - Country:US
Mailing Address - Phone:214-373-8100
Mailing Address - Fax:214-234-0192
Practice Address - Street 1:10910 N CENTRAL EXPY
Practice Address - Street 2:SUITE #700
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2500
Practice Address - Country:US
Practice Address - Phone:214-373-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-15
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier