Provider Demographics
NPI:1104251529
Name:J&L OPTICAL DBA PER-FIT VISION
Entity type:Organization
Organization Name:J&L OPTICAL DBA PER-FIT VISION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LUONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-681-2554
Mailing Address - Street 1:1440 LAKE WOODLANDS DR
Mailing Address - Street 2:SUTIE F
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3273
Mailing Address - Country:US
Mailing Address - Phone:281-681-2554
Mailing Address - Fax:281-298-3716
Practice Address - Street 1:1440 LAKE WOODLANDS DR
Practice Address - Street 2:SUITE F
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-3273
Practice Address - Country:US
Practice Address - Phone:281-681-2552
Practice Address - Fax:281-491-5611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty