Organization · Type 2 NPI

Sam's East, Inc.

Eyewear Supplier · Austin, TX

NPI number 1639574338 Active

Practice location

10901 Lakeline Mall Dr.
Austin, TX 78717

Call (479) 273-4000 Map

Mailing address

702 SW 8th St
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Optician	156FX1800X	None listed
Eyewear Supplier Primary	332H00000X	None listed

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

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NPI record

NPI: 1639574338
Entity type: Organization (Type 2)
Issued: Oct 24, 2014
Last updated: Oct 24, 2014
Status: Active
Subpart: Yes of Wal-Mart Stores, Inc.

Other names

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Sam's Club Vision Center 30-6188 · doing business as

Authorized official

Laura Levine
Director Healthcare Contracting
(479) 204-8550

Verify this record

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 1639574338

Sam's East, Inc.'s National Provider Identifier is 1639574338, issued on Oct 24, 2014. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Austin, TX. The record was last updated on Oct 24, 2014.