Provider Demographics
NPI:1053174474
Name:AHPTICAL LLC
Entity type:Organization
Organization Name:AHPTICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:M
Authorized Official - Last Name:HENTGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-743-1960
Mailing Address - Street 1:106 KEUPER AVE
Mailing Address - Street 2:
Mailing Address - City:SCHULENBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78956-1129
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:115 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:SCHULENBURG
Practice Address - State:TX
Practice Address - Zip Code:78956
Practice Address - Country:US
Practice Address - Phone:979-743-1960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier