Daniel Max & Marcandrea LLC
Eyewear Supplier (Equipment, not the service) in Fort Worth, TX. Organization (NPI-2).
NPI number1144782889
StatusActive
Last updated in NPPESFeb 19, 2021
Details
- NPI
- 1144782889
- Entity type
- Organization (NPI-2)
- Legal business name
- Daniel Max & Marcandrea LLC
- Organization subpart
- No
- Enumeration date
- Apr 2, 2019
- Certification date
- Feb 19, 2021
- Last updated
- Feb 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – | Yes |
Practice location
8901 North Fwy Ste 105Fort Worth, TX 76177-7655
Phone 682-350-2605 · Fax 561-828-8367
Mailing address
3801 S Congress AvePalm Springs, FL 33461-4140
Phone 561-275-2020 · Fax 561-275-2030
Authorized official
Jackie Bennett
Credentialing Manager
5616124531
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