Organization · NPI-2

Mel Vision LLC

Eyewear Supplier (Equipment, not the service) · Denton, TX

NPI number1508463522
StatusActive
Last updated in NPPESFeb 19, 2021

Details

NPI
1508463522
Entity type
Organization (NPI-2)
Legal business name
Mel Vision LLC
Organization subpart
No
Enumeration date
Oct 2, 2020
Certification date
Feb 19, 2021
Last updated
Feb 19, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
332H00000X Eyewear Supplier (Equipment, not the service)––Yes

Other names

  • My Eyelab (Doing Business As)

Practice location

2505 W University Dr # 1015
Denton, TX 76201-1629

Phone 940-268-2100 · Fax 561-828-8367

Mailing address

2199 Glenmore Ln
Snellville, GA 30078-5611

Authorized official

Jackie Bennett
Credentialing Supervisor
5616124531

Is something wrong?

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