Provider Demographics
NPI:1740595404
Name:VEINTE VEINTE GROUP, LLC.,
Entity Type:Organization
Organization Name:VEINTE VEINTE GROUP, LLC.,
Other - Org Name:OPTICA VEINTE VEINTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-592-1010
Mailing Address - Street 1:8080 GATEWAY BLVD E STE 101
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-1276
Mailing Address - Country:US
Mailing Address - Phone:915-592-2020
Mailing Address - Fax:915-921-1455
Practice Address - Street 1:8080 GATEWAY BLVD E STE 101
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907-1276
Practice Address - Country:US
Practice Address - Phone:915-592-2020
Practice Address - Fax:915-921-1544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier