Organization
FUNKHOUSER OPTICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE MELVIN FUNKHOUSER (OWNER)
(903) 677-1985
Entity
Organization
Contact information
Practice address
1206 S PALESTINE ST, ATHENS, TX 75751-3619
(903) 677-1985
(903) 677-2099
Mailing address
PO BOX 952, ATHENS, TX 75751-0952
(903) 677-1985
(903) 677-2099
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066298301
—
TX
05
—
149257101
—
TX
01
—
528354
BCBS OF TX
—
Enumeration date
01/08/2008
Last updated
05/21/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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