Provider Demographics
NPI:1952008971
Name:HANSRA OPTOMETRIC CORPORATION
Entity type:Organization
Organization Name:HANSRA OPTOMETRIC CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GULROOP
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSRA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-347-4219
Mailing Address - Street 1:175 E HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-2299
Mailing Address - Country:US
Mailing Address - Phone:726-444-4078
Mailing Address - Fax:210-524-6587
Practice Address - Street 1:23625 EL TORO RD STE E
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-4728
Practice Address - Country:US
Practice Address - Phone:949-227-2524
Practice Address - Fax:949-446-6591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-09
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier