Provider Demographics
NPI:1366659336
Name:REAL OPTICS INC
Entity Type:Organization
Organization Name:REAL OPTICS INC
Other - Org Name:VOGUE VISION AT K-SCOPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISAK
Authorized Official - Middle Name:
Authorized Official - Last Name:SIVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-244-7740
Mailing Address - Street 1:555 WALNUT #204
Mailing Address - Street 2:KALEIDOSCOPE MALL
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309
Mailing Address - Country:US
Mailing Address - Phone:515-243-3020
Mailing Address - Fax:515-243-6911
Practice Address - Street 1:555 WALNUT #204
Practice Address - Street 2:KALEIDOSCOPE MALL
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309
Practice Address - Country:US
Practice Address - Phone:515-243-3020
Practice Address - Fax:515-243-6911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier