Organization
SOUTHWEST OPTOMETRIC ASSOCIATES P C
Active
Other names
Miami Optical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY GEORGE HAUSER OD (PRESIDENT)
(773) 890-1100
Entity
Organization
Contact information
Practice address
3125 S ASHLAND AVE, STE 204, CHICAGO, IL 60608-6252
(773) 890-1100
Mailing address
3125 S ASHLAND AVE, STE 204, CHICAGO, IL 60608-6252
(773) 890-1100
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
060005752
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
987570
MEDICARE PTAN
—
01
—
CG7477
RAILROAD MEDICARE
—
Enumeration date
08/09/2006
Last updated
07/11/2013
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