Organization
KILGORE-GILMER EYE CARE CENTERS P.A.
Active
Other names
Kilgore Eye Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY TED ROBERTS O.D. (OWNER)
(903) 983-2020
Entity
Organization
Contact information
Practice address
1100 STONE RD, SUITE 2020, KILGORE, TX 75662-5482
(903) 983-2020
(903) 983-4000
Mailing address
PO BOX 8000, KILGORE, TX 75663-8000
(903) 983-2020
(903) 983-4000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2344TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00E45Y
BLUE CROSS BLUE SHIELD
TX
05
—
019369001
—
TX
01
—
410022897
PALMETTO GBA-RAILROAD MED
TX
Enumeration date
07/05/2006
Last updated
09/25/2017
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