Individual
MR. MIKE EARL BUTAUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
128 N AUSTIN STREET, JASPER, TX 75951
(409) 383-1120
Mailing address
128 N AUSTIN STREET, JASPER, TX 75951
(409) 383-1120
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
02/15/2008
Last updated
02/15/2008
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