Provider Demographics
NPI:1275857765
Name:JCQUES FAMILY OPTICAL
Entity Type:Organization
Organization Name:JCQUES FAMILY OPTICAL
Other - Org Name:PRICE POINT OPTICAL
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JACQUES
Authorized Official - Middle Name:SOARES
Authorized Official - Last Name:LACE
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:469-229-0341
Mailing Address - Street 1:3131 CUSTER RD
Mailing Address - Street 2:S/ 155
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-4419
Mailing Address - Country:US
Mailing Address - Phone:469-229-0341
Mailing Address - Fax:469-467-2459
Practice Address - Street 1:3131 CUSTER RD
Practice Address - Street 2:S/ 155
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-4419
Practice Address - Country:US
Practice Address - Phone:469-229-0341
Practice Address - Fax:469-467-2459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier