Organization
BRONAUGH INDEPENDENT OPTICIANS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARDA P BRONAUGH (CORPORATE PRESIDENT)
(936) 632-1010
Entity
Organization
Contact information
Practice address
109 GASLIGHT BLVD, LUFKIN, TX 75904-3167
(936) 632-1010
(936) 632-3233
Mailing address
109 GASLIGHT BLVD, LUFKIN, TX 75904-3167
(936) 632-1010
(936) 632-3233
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005524399
AETNA
KY
05
—
086517201
—
TX
01
—
0906860002
SUPERIOR VISION SERVICES INC
CA
01
—
0906860002
AMERITAS LIFE INSURANCE CORP
NE
01
—
0906860002
TRICARE HUMANA MILITARY HEALTHCARE SERVICES
SC
01
—
0906860002
TRS ACTIVCARE
TX
01
—
32603
OPTICARE MANAGED VISION
TX
01
—
4007229
BLUE CROSS BLUE SHIELD OF TENNESSEE
TN
01
—
504262
BLUE CROSS BLUE SHIELD OF TEXAS
TX
01
—
5090961
CONNECTICUT GENERAL LIFE INSURANCE CO
CT
01
—
80112
AVESIS
AZ
01
—
908788
BLOCK VISION OF TEXAS INC
TX
01
—
925101
BLOCK VISION OF TEXAS
TX
01
—
OP1740
EYEMED VISION CARE
OH
Enumeration date
05/21/2008
Last updated
05/21/2008
Update your record
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