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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
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