Organization
STEPHENVILLE OPTICAL, PA
Active
Other names
TEXAS STATE OPTICAL
Organization subpart
No
Provider details
NPI number
Authorized official
DEY RODRIGUEZ (OFFICE MANAGER)
(254) 968-4133
Entity
Organization
Contact information
Practice address
101 N DALE AVE, STEPHENVILLE, TX 76401-2832
(254) 968-4133
(254) 968-5631
Mailing address
101 N DALE AVE, STEPHENVILLE, TX 76401-2832
(254) 968-4133
(254) 968-5631
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1123911-01
—
TX
Enumeration date
04/04/2007
Last updated
06/09/2017
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