Organization
SMAZY ENTERPRISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE BENNETT (CREDENTIALING MANAGER)
(561) 433-6009
Entity
Organization
Contact information
Practice address
W. AIRPORT FREEWAY, STE 122, IRVING, TX 75062
(561) 275-2020
Mailing address
3401 W AIRPORT FWY STE 122, IRVING, TX 75062-5930
(469) 665-8800
(561) 828-8367
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
05/22/2019
Last updated
02/17/2021
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