Organization
BUENA VISTA OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD GILLETT III M.D (DOCTOR)
(956) 631-1951
Entity
Organization
Contact information
Practice address
521 S 10TH ST, MCALLEN, TX 78501-4949
(956) 631-1951
(956) 683-1625
Mailing address
521 S 10TH ST, MCALLEN, TX 78501-4949
(956) 631-1951
(956) 683-1625
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
H8656
TX
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
162690501
OPTICARE
TX
05
—
162690501
—
TX
Enumeration date
02/06/2007
Last updated
03/03/2022
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