Mockingbird Optical Shop LLC
NPI #1194728337 in San Antonio, Texas
Provider Information
- NPI Number
- 1194728337
- Entity Type
- Organization
- Organization Name
- Mockingbird Optical Shop LLC
- Primary Specialty
- Durable Medical Equipment & Medical Supplies - Customized Equipment
- Enumeration Date
- May 23, 2005
- Last Updated
- Feb 27, 2015
Practice Location
- Address
- 5430 FREDERICKSBURG RD
- Address 2
- STE 100
- City
- San Antonio
- State
- Texas
- ZIP Code
- 78229-3539
- Phone
- (210) 340-1212
Authorized Official
- Name
- JAY C. COLLINS
- Title
- ADMINISTRATOR
- Phone
- (210) 340-1212
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies - Customized Equipment — Customized Equipment |
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