Provider Demographics
NPI:1619551272
Name:OCULUS EYEWEAR, LLC
Entity Type:Organization
Organization Name:OCULUS EYEWEAR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-396-1500
Mailing Address - Street 1:2430 S IH 35 STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-5921
Mailing Address - Country:US
Mailing Address - Phone:512-396-1500
Mailing Address - Fax:
Practice Address - Street 1:2430 S IH 35 STE 110
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5921
Practice Address - Country:US
Practice Address - Phone:512-396-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies