Organization
AVS VISION CRESTVIEW 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
12901 N INTERSTATE 35 STE 1305A, AUSTIN, TX 78753-1019
(561) 275-2020
Mailing address
5228 RUFE SNOW DR, NORTH RICHLAND HILLS, TX 76180-6652
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
08/30/2021
Last updated
10/11/2021
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