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Organization
OPTICAL HEADQUARTERS
Active
Organization
OPTICAL HEADQUARTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LONNIE NEAL FUSSELL (OWNER)
(210) 735-3507
Entity
Organization
Contact information
Practice address
1710 FREDERICKSBURG RD, SAN ANTONIO, TX 78201-5033
(210) 735-3507
(210) 735-1811
Mailing address
1710 FREDERICKSBURG RD, SAN ANTONIO, TX 78201-5033
(210) 735-3507
(210) 735-1811
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
NULL
Other
Enumeration date
05/29/2007
Last updated
06/27/2008
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