Provider Demographics
NPI:1023286895
Name:TWIN CITY OPTICAL CORP
Entity type:Organization
Organization Name:TWIN CITY OPTICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BARCAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-342-1610
Mailing Address - Street 1:1601 MAIN STREET
Mailing Address - Street 2:SUITE 109
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3230
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1601 MAIN STREET
Practice Address - Street 2:SUITE 109
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-3230
Practice Address - Country:US
Practice Address - Phone:281-342-1610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
5990960001Medicare NSC