Organization
LIFETIME VISION CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC GEORGE BERGERON (OWNER)
(512) 244-2003
Entity
Organization
Contact information
Practice address
408 N. MAYS ST., ROUND ROCK, TX 78664
(512) 244-2003
Mailing address
408 N. MAYS ST., ROUND ROCK, TX 78664
(512) 244-2003
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2584T
TX
Other
Enumeration date
10/02/2006
Last updated
11/13/2008
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