Organization
CYNTHIA LACY-STALLWORTH, O.D. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA LACY-STALLWORTH O.D. (OPTOMETRIST)
(713) 734-5376
Entity
Organization
Contact information
Practice address
1615 S LOOP W, HOUSTON, TX 77054-4814
(713) 796-2216
(713) 383-7612
Mailing address
1615 S LOOP W, HOUSTON, TX 77054-4814
(713) 796-2216
(713) 383-7612
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
06786T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01560081
—
PA
Enumeration date
07/23/2007
Last updated
07/23/2007
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