Provider Demographics
NPI:1225329626
Name:EYEMAX OPTICAL INC.
Entity Type:Organization
Organization Name:EYEMAX OPTICAL INC.
Other - Org Name:EYEMAX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MALIK
Authorized Official - Middle Name:
Authorized Official - Last Name:MAMDANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-850-8001
Mailing Address - Street 1:1515 N TOWN EAST BLVD
Mailing Address - Street 2:SUITE 523
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-4157
Mailing Address - Country:US
Mailing Address - Phone:972-850-8001
Mailing Address - Fax:
Practice Address - Street 1:1515 N TOWN EAST BLVD
Practice Address - Street 2:SUITE 523
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4157
Practice Address - Country:US
Practice Address - Phone:972-850-8001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier