Provider Demographics
NPI:1477752855
Name:SUNLAND OPTICAL CO INC
Entity Type:Organization
Organization Name:SUNLAND OPTICAL CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-591-9483
Mailing Address - Street 1:1156 BARRANCA
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935
Mailing Address - Country:US
Mailing Address - Phone:915-591-9483
Mailing Address - Fax:915-225-0698
Practice Address - Street 1:1156 BARRANCA
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935
Practice Address - Country:US
Practice Address - Phone:915-591-9483
Practice Address - Fax:915-225-0698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1037590001Medicare NSC