Organization
SAM'S EAST INC
Active
Other names
Sam's Optical Center 30-6376, Sam's Club Optical 30-6376
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SR DIRECTOR)
(480) 853-0515
Entity
Organization
Contact information
Practice address
4062 LBJ FWY, DALLAS, TX 75244-5701
(972) 934-3727
(972) 241-3531
Mailing address
1 CUSTOMER DR, MS 0445, BENTONVILLE, AR 72716-0235
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
10/31/2006
Last updated
06/15/2026
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