Organization
FIFTH AVENUE EYEWEAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANICE KAY FAULKNER (OWNER)
(817) 870-1291
Entity
Organization
Contact information
Practice address
1223 5TH AVE, FORT WORTH, TX 76104-4304
(817) 870-1291
(817) 870-4928
Mailing address
1223 5TH AVE, FORT WORTH, TX 76104-4304
(817) 870-1291
(817) 870-4928
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DR3962
TX
Other
Enumeration date
03/09/2007
Last updated
08/22/2020
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