Provider Demographics
NPI:1366967697
Name:SAVE OPTICAL INC
Entity type:Organization
Organization Name:SAVE OPTICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:KOCHINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICAIN
Authorized Official - Phone:713-645-7165
Mailing Address - Street 1:PO BOX 321045
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77221-1045
Mailing Address - Country:US
Mailing Address - Phone:832-754-3811
Mailing Address - Fax:
Practice Address - Street 1:5320 GRIGGS RD STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-3715
Practice Address - Country:US
Practice Address - Phone:713-242-9050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-08
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332H00000X
TX29567156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX454271304Medicaid