OrganizationActive
Daniel Max & Marcandrea LLC
NPI 1053879569 · Eyewear Supplier · Fort Worth, TX
Provider details
- NPI number
- 1053879569
- Entity type
- Organization
- Primary specialty
- Eyewear SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Jackie Bennett, Credentialing Manager(561) 612-4531
Specialties & taxonomies
Suppliers
Practice location
501 Alta Mere Dr Ste 1021
Fort Worth, TX 76114-4014
Phone: (817) 502-6330
Fax: (561) 828-8367
Approximate (ZIP-level) locationGet directions
Mailing address
3801 S Congress Ave
Palm Springs, FL 33461-4140
Other names (DBA / former)
- Doing business as
- My Eyelab
Registry dates
- Enumerated
- 2019-03-05
- Last updated
- 2021-02-19
- Certified
- 2021-02-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.