Organization
MEL VISION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE BENNETT (CREDENTIALING SPECIALIST)
(561) 612-4531
Entity
Organization
Contact information
Practice address
6471 E NORTHWEST HWY STE 130, DALLAS, TX 75231-8007
(469) 513-1047
(561) 828-8367
Mailing address
2199 GLENMORE LN, SNELLVILLE, GA 30078-5611
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
10/02/2020
Last updated
02/19/2021
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