# LYLE THORSTENSON MD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Thorstenson Eye Clinic Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134236714
- **Authorized official:** PAMELA R THORSTENSON (ADMINISTRATOR)
- **Authorized official phone:** (936) 564-2411

## Contact information

- **Practice address:** 3302 NE STALLINGS DR, NACOGDOCHES, TX 75965-8727
- **Practice address phone:** (936) 564-2411
- **Practice address fax:** (936) 564-1280
- **Mailing address:** PO BOX 632020, NACOGDOCHES, TX 75963-2020
- **Mailing address phone:** (936) 564-2411
- **Mailing address fax:** (936) 564-1280

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 000273 | TX | Yes |

## Other

- **Enumeration date:** 08/23/2006
- **Last updated:** 08/22/2020