Organization
MEL ROCKWALL LLC
Active
Other names
My Eyelab
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE BENNETT (CREDENTIALING SUPERVISOR)
(561) 433-6009
Entity
Organization
Contact information
Practice address
1701 E BROAD ST STE 109, MANSFIELD, TX 76063-4349
(682) 341-3921
(561) 828-8367
Mailing address
1784 W MCDERMOTT DR STE 110, ALLEN, TX 75013-3395
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
12/09/2019
Last updated
02/19/2021
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