Provider Demographics
NPI:1417165226
Name:REAL OPTICS INC
Entity Type:Organization
Organization Name:REAL OPTICS INC
Other - Org Name:VOGUE VISION IN CARROLL
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 1:214 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CARROLL
Mailing Address - State:IA
Mailing Address - Zip Code:51401-2721
Mailing Address - Country:US
Mailing Address - Phone:712-792-4878
Mailing Address - Fax:712-792-6210
Practice Address - Street 1:214 W 5TH ST
Practice Address - Street 2:
Practice Address - City:CARROLL
Practice Address - State:IA
Practice Address - Zip Code:51401-2721
Practice Address - Country:US
Practice Address - Phone:712-792-4878
Practice Address - Fax:712-792-6210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier