Individual
DANIEL K GULLEKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(210) 292-1055
Mailing address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(210) 292-1055
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0003037
CO
152W00000X
Optometrist
05658T
TX
Other
Enumeration date
09/29/2005
Last updated
06/09/2020
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