Organization · Type 2 NPI

Costco Wholesale Corporation

Eyewear Supplier · Fort Worth, TX

NPI number 1356735625 Active

Practice location

8900 Tehama Ridge Pkwy
Fort Worth, TX 76177-2004

Call (817) 806-9833 Map

Fax (817) 806-9844

Mailing address

PO Box 35005
Seattle, WA 98124-3405

Specialties and licenses

Taxonomy	Code	License
Eyewear Supplier Primary	332H00000X	CP20045 (TX)

Eyewear Supplier: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

4 other providers at this address

Other eyewear supplier providers in Fort Worth

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NPI record

NPI: 1356735625
Entity type: Organization (Type 2)
Issued: Mar 25, 2015
Last updated: Mar 4, 2020
Status: Active
Subpart: Yes of Costco Wholesale Corporation

Other names

<unavail>
Costco Optical #1173 · doing business as
Costco Optical #1173 · doing business as

Authorized official

Art Salas
AVP Optical
(817) 806-9833

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1356735625

Costco Wholesale Corporation's National Provider Identifier is 1356735625, issued on Mar 25, 2015. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Fort Worth, TX. The record was last updated on Mar 4, 2020.