Provider Demographics
NPI: | 1033217195 |
---|---|
Name: | I & N OPTICAL, INC. |
Entity type: | Organization |
Organization Name: | I & N OPTICAL, INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | ISAAK |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | GREENSTEIN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 817-370-1811 |
Mailing Address - Street 1: | 6813 GREEN OAKS RD |
Mailing Address - Street 2: | |
Mailing Address - City: | FT WORTH |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 76116-1713 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 817-731-7434 |
Mailing Address - Fax: | 817-738-2043 |
Practice Address - Street 1: | 6813 GREEN OAKS RD |
Practice Address - Street 2: | |
Practice Address - City: | FT WORTH |
Practice Address - State: | TX |
Practice Address - Zip Code: | 76116-1713 |
Practice Address - Country: | US |
Practice Address - Phone: | 817-731-7434 |
Practice Address - Fax: | 817-738-2043 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-09-20 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | BLOCK VISION | Other | 919511 |