Individual
DR. CHARLES LEE STOCKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3601 4TH ST # 2A100, LUBBOCK, TX 79430-3530
(281) 455-8955
Mailing address
5109 82ND ST, SUITE 7-214, LUBBOCK, TX 79424-3028
(281) 455-8955
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2242TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019517401
—
TX
01
—
1182800001
DMERC-NSC
—
01
—
410030400
RAILROAD MEDICARE
—
Enumeration date
11/20/2006
Last updated
07/21/2022
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