Provider Demographics
NPI:1275702144
Name:JOHN F. REITER OPTICIANS LLC
Entity Type:Organization
Organization Name:JOHN F. REITER OPTICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-422-8339
Mailing Address - Street 1:114 E TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-5255
Mailing Address - Country:US
Mailing Address - Phone:281-422-8339
Mailing Address - Fax:
Practice Address - Street 1:114 E TEXAS AVE
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-5255
Practice Address - Country:US
Practice Address - Phone:281-422-8339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5878660001Medicare NSC