Provider Demographics
NPI:1326389818
Name:HOPTICAL
Entity Type:Organization
Organization Name:HOPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WILEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-637-0834
Mailing Address - Street 1:423 CALLE SAN JULIAN
Mailing Address - Street 2:URB. SAGRADO CORAZON
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4243
Mailing Address - Country:US
Mailing Address - Phone:787-637-0834
Mailing Address - Fax:
Practice Address - Street 1:CARR. 172, URB. TURABO GARDENS
Practice Address - Street 2:HOSPITAL MENONITA CAGUAS, PRIMER PISO
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-637-0834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOPTICAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-07
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR464152W00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No332H00000XSuppliersEyewear SupplierGroup - Multi-Specialty