Provider Demographics
NPI:1326490152
Name:GESU OPTICAL LLC
Entity Type:Organization
Organization Name:GESU OPTICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KIRSTEN
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-807-2873
Mailing Address - Street 1:2111 S COLLINS ST STE 204
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-8548
Mailing Address - Country:US
Mailing Address - Phone:817-385-0044
Mailing Address - Fax:817-549-8340
Practice Address - Street 1:835 E LAMAR BLVD
Practice Address - Street 2:SUITE 469
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-3504
Practice Address - Country:US
Practice Address - Phone:817-385-0044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier