Organization
DEHAVEN OPTICAL CENTER
Active
Other names
LoneStar Optical
Organization subpart
No
Provider details
NPI number
Authorized official
GINA LOWNDES (FINANCIAL SERVICE MANAGER)
(903) 595-7510
Entity
Organization
Contact information
Practice address
908 NORTH PACIFIC, MINEOLA, TX 75773-1836
(903) 569-9945
(903) 569-9974
Mailing address
908 NORTH PACIFIC, MINEOLA, TX 75773-1836
(903) 595-4144
(903) 526-5491
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203580001
—
TX
Enumeration date
09/05/2008
Last updated
04/17/2017
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