Provider Demographics
NPI:1821746173
Name:OPTICA EYEWEAR LLC
Entity Type:Organization
Organization Name:OPTICA EYEWEAR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ESCOBEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-561-4016
Mailing Address - Street 1:2921 BOCA CHICA BLVD STE 23B
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-2386
Mailing Address - Country:US
Mailing Address - Phone:956-561-4016
Mailing Address - Fax:956-561-4013
Practice Address - Street 1:2921 BOCA CHICA BLVD STE 23B
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-2386
Practice Address - Country:US
Practice Address - Phone:956-561-4016
Practice Address - Fax:956-561-4013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier