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Organization
TRINA LIESKE OD PA
Active
Organization
TRINA LIESKE OD PA
Active
Other names
Vision City of Lake Worth
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRINA LIESKE O.D. (OWNER)
(817) 546-9000
Entity
Organization
Contact information
Practice address
5412 BOAT CLUB RD STE 150, FORT WORTH, TX 76135-1205
(817) 546-9000
(817) 546-1126
Mailing address
5412 BOAT CLUB RD STE 150, FORT WORTH, TX 76135-1205
(817) 546-9000
(817) 546-1126
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0030FG
BCBS PROVIDER #
TX
Enumeration date
07/11/2007
Last updated
12/28/2021
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