Individual
DR. JERRY LEE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
103 W LOOP 281, STE 450, LONGVIEW, TX 75605-4653
(903) 663-2020
(903) 663-2353
Mailing address
103 W LOOP 281, SUITE 450, LONGVIEW, TX 75605-4653
(903) 663-2020
(903) 663-2353
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2926TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093291502
—
TX
Enumeration date
11/16/2006
Last updated
07/23/2008
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