Provider Demographics
NPI:1699362053
Name:URBAN EYEWEAR INC
Entity Type:Organization
Organization Name:URBAN EYEWEAR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NIXEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-559-1824
Mailing Address - Street 1:2266 JUAN ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-1159
Mailing Address - Country:US
Mailing Address - Phone:805-559-1824
Mailing Address - Fax:
Practice Address - Street 1:8843 VILLA LA JOLLA DR STE 201
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1964
Practice Address - Country:US
Practice Address - Phone:619-539-7279
Practice Address - Fax:619-310-6956
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:URBAN EYEWEAR INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier