Provider Demographics
NPI:1396771648
Name:SIGHTS MY LINE, INC
Entity type:Organization
Organization Name:SIGHTS MY LINE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEWART
Authorized Official - Middle Name:
Authorized Official - Last Name:LANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-618-0866
Mailing Address - Street 1:1804 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-5402
Mailing Address - Country:US
Mailing Address - Phone:956-687-2875
Mailing Address - Fax:956-687-3128
Practice Address - Street 1:1709 S 77 SUNSHINESTRIP
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8121
Practice Address - Country:US
Practice Address - Phone:956-423-7884
Practice Address - Fax:956-423-7885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX153679902Medicaid
TX4562050004Medicare NSC