Optical Headquarters
NPI #1265633119 in San Antonio, Texas
Provider Information
- NPI Number
- 1265633119
- Entity Type
- Organization
- Organization Name
- Optical Headquarters
- Primary Specialty
- Non-Pharmacy Dispensing Site
- Enumeration Date
- May 29, 2007
- Last Updated
- Jun 27, 2008
Practice Location
- Address
- 1710 FREDERICKSBURG RD
- City
- San Antonio
- State
- Texas
- ZIP Code
- 78201-5033
- Phone
- (210) 735-3507
Authorized Official
- Name
- MR. LONNIE NEAL FUSSELL
- Title
- OWNER
- Phone
- (210) 735-3507
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-Pharmacy Dispensing Site |
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