Organization
DE LA TORRE OPTICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALFRED G DE LA TORRE (OWNER)
(214) 941-3582
Entity
Organization
Contact information
Practice address
2120 W COLORADO BLVD, DALLAS, TX 75211-1900
(214) 941-3582
(214) 941-2468
Mailing address
2120 W COLORADO BLVD, DALLAS, TX 75211-1900
(214) 941-3582
(214) 941-2468
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
0042192
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19415
SPECTERA UNITEDHEALTHCARE
TX
01
—
509158
BLUE CROSS BLUE SHIELD
TX
01
—
895555
SUPERIOR VISION
TX
01
—
917563
BLOCKVISION OF TEXAS
TX
Enumeration date
12/18/2007
Last updated
02/05/2008
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