Provider Demographics
NPI:1700057890
Name:STANLEY B JONES,
Entity Type:Organization
Organization Name:STANLEY B JONES,
Other - Org Name:THE OPTICAL SHOP, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:BURTON
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:214-821-0200
Mailing Address - Street 1:7324 GASTON AVE. #123
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-6194
Mailing Address - Country:US
Mailing Address - Phone:214-821-0200
Mailing Address - Fax:214-821-0201
Practice Address - Street 1:7324 GASTON AVE STE 123
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-6190
Practice Address - Country:US
Practice Address - Phone:214-821-0200
Practice Address - Fax:214-821-0201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FX1800X, 332H00000X
TXDR4033332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1190160001Medicare NSC