Provider Demographics
NPI:1962763680
Name:JUST VISION OPTICAL, LLC
Entity type:Organization
Organization Name:JUST VISION OPTICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:210-675-1515
Mailing Address - Street 1:1503 SW LOOP 410
Mailing Address - Street 2:SUITE 113
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78227-1677
Mailing Address - Country:US
Mailing Address - Phone:210-675-1515
Mailing Address - Fax:210-675-1557
Practice Address - Street 1:1503 SW LOOP 410
Practice Address - Street 2:SUITE 113
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-1677
Practice Address - Country:US
Practice Address - Phone:210-675-1515
Practice Address - Fax:210-675-1557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier