Provider Demographics
NPI: | 1912134925 |
---|---|
Name: | BETTER OPTICS INC |
Entity Type: | Organization |
Organization Name: | BETTER OPTICS INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OPTOMETRIST |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | LUIS |
Authorized Official - Middle Name: | GABRIEL |
Authorized Official - Last Name: | PEREZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OD |
Authorized Official - Phone: | 903-880-4393 |
Mailing Address - Street 1: | 4419 HOLLAND AVE |
Mailing Address - Street 2: | 104 |
Mailing Address - City: | DALLAS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75219-2134 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 903-880-4393 |
Mailing Address - Fax: | 903-880-0108 |
Practice Address - Street 1: | 1200 W MAIN ST |
Practice Address - Street 2: | |
Practice Address - City: | GUN BARREL CITY |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75156-5320 |
Practice Address - Country: | US |
Practice Address - Phone: | 903-880-4393 |
Practice Address - Fax: | 903-880-0108 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-06-17 |
Last Update Date: | 2009-06-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 6799TG | 152W00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Single Specialty |