Provider Demographics
NPI:1407430697
Name:PINAL, MARIA (TU OPTICAL)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:PINAL
Suffix:
Gender:F
Credentials:TU OPTICAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7401 S CAGE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-9053
Mailing Address - Country:US
Mailing Address - Phone:956-483-2974
Mailing Address - Fax:956-483-2974
Practice Address - Street 1:7401 S CAGE BLVD STE B
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-9053
Practice Address - Country:US
Practice Address - Phone:956-483-2974
Practice Address - Fax:956-483-2974
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-12
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier