Provider Demographics
NPI:1225170012
Name:SPECTERA INC
Entity Type:Organization
Organization Name:SPECTERA INC
Other - Org Name:UNITED OPTICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:VP DIRECTOR OF OPTICAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:HEETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-316-2061
Mailing Address - Street 1:2811 LORD BALTIMORE DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244
Mailing Address - Country:US
Mailing Address - Phone:443-316-2101
Mailing Address - Fax:410-265-6068
Practice Address - Street 1:2811 LORD BALTIMORE DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244
Practice Address - Country:US
Practice Address - Phone:443-316-2101
Practice Address - Fax:410-265-6068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Not Answered332H00000XSuppliersEyewear Supplier