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Organization

B J RUST JR

Active
Other names
Optical Service
Organization subpart
No

Provider details

NPI number
Authorized official
MR. B. J. RUST JR. OPTICIAN (OPTICIAN)
(817) 338-1121
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
DR0128
TX

Other

Enumeration date
05/22/2007
Last updated
11/03/2008
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