# B J RUST JR

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Optical Service
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346459500
- **Authorized official:** MR. B. J. RUST JR. OPTICIAN (OPTICIAN)
- **Authorized official phone:** (817) 338-1121

## Contact information

- **Practice address:** 4825 CAMP BOWIE BLVD, FORT WORTH, TX 76107-4150
- **Practice address phone:** (817) 731-4646
- **Practice address fax:** (817) 731-4646
- **Mailing address:** 4825 CAMP BOWIE BLVD, FORT WORTH, TX 76107-4150
- **Mailing address phone:** (817) 731-4646
- **Mailing address fax:** (817) 731-4646

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | DR0128 | TX | Yes |

## Other

- **Enumeration date:** 05/22/2007
- **Last updated:** 11/03/2008