Organization
E & S MANAGEMENT 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
25 NE LOOP 410 STE 130, SAN ANTONIO, TX 78216-8405
(561) 275-2020
Mailing address
3008 DAWN DR STE 105, GEORGETOWN, TX 78628-2822
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
11/10/2021
Last updated
11/10/2021
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