Provider Demographics
NPI:1144421116
Name:LENS PRO XPRESS
Entity Type:Organization
Organization Name:LENS PRO XPRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDRICK
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:GRUBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-664-9200
Mailing Address - Street 1:1700 S 10TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-5415
Mailing Address - Country:US
Mailing Address - Phone:956-664-9200
Mailing Address - Fax:956-664-9803
Practice Address - Street 1:1700 S 10TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-5415
Practice Address - Country:US
Practice Address - Phone:956-664-9200
Practice Address - Fax:956-664-9803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier