Provider Demographics
NPI:1447330949
Name:WILLS OPTICAL OF GARLAND INC
Entity type:Organization
Organization Name:WILLS OPTICAL OF GARLAND INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER VP
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:ROSANNE
Authorized Official - Last Name:WILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-271-3930
Mailing Address - Street 1:3034 BROADWAY BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041
Mailing Address - Country:US
Mailing Address - Phone:972-271-3930
Mailing Address - Fax:972-840-6680
Practice Address - Street 1:3034 BROADWAY BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041
Practice Address - Country:US
Practice Address - Phone:972-271-3930
Practice Address - Fax:972-840-6680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1323690001Medicare ID - Type Unspecified