Organization · Type 2 NPI

Costco Wholesale Corporation

Eyewear Supplier · Southlake, TX

NPI number 1417341801 Active

Practice location

2601 E State Highway 114
Southlake, TX 76092-6668

Call (817) 749-2800 Map

Fax (817) 749-2817

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.

7 other providers at this address

Other eyewear supplier providers in Southlake

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NPI record

NPI: 1417341801
Entity type: Organization (Type 2)
Issued: Mar 24, 2015
Last updated: Mar 4, 2020
Status: Active
Subpart: Yes of Costco Wholesale Corporation

Other names

<unavail>
Costco Optical #669 · doing business as
Costco Optical #669 · doing business as

Authorized official

Art Salas
AVP Optical
(817) 749-2801

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About NPI 1417341801

Costco Wholesale Corporation's National Provider Identifier is 1417341801, issued on Mar 24, 2015. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Southlake, TX. The record was last updated on Mar 4, 2020.