Provider Demographics
NPI:1508274317
Name:PUSPA'S OPTICAL BOUTIQUE
Entity Type:Organization
Organization Name:PUSPA'S OPTICAL BOUTIQUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PUSPABEN
Authorized Official - Middle Name:DAYHABHAI
Authorized Official - Last Name:STURGHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-749-5717
Mailing Address - Street 1:11242 FM 1960 RD WEST - SUITE 106
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3635
Mailing Address - Country:US
Mailing Address - Phone:281-955-5080
Mailing Address - Fax:281-955-5080
Practice Address - Street 1:11242 FM 1960 RD. WEST - SUITE 106
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3635
Practice Address - Country:US
Practice Address - Phone:281-955-5080
Practice Address - Fax:281-955-5080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier