Provider Demographics
NPI:1831752260
Name:THE EYEGLASS REPAIR GUYS LLC
Entity type:Organization
Organization Name:THE EYEGLASS REPAIR GUYS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BRIEANA
Authorized Official - Middle Name:JANI
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-410-8203
Mailing Address - Street 1:2825 N MAIN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-5565
Mailing Address - Country:US
Mailing Address - Phone:281-410-8203
Mailing Address - Fax:
Practice Address - Street 1:2825 N MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-5565
Practice Address - Country:US
Practice Address - Phone:281-410-8203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-22
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier