Organization
TRUSSELL THANE OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATRINA L THANE (MANAGER)
(325) 773-2083
Entity
Organization
Contact information
Practice address
1501 COLUMBIA ST, STAMFORD, TX 79553-6832
(325) 773-2083
(325) 773-2526
Mailing address
1501 COLUMBIA ST, STAMFORD, TX 79553-6832
(325) 773-2083
(325) 773-2526
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
4720TG
TX
Other
Enumeration date
03/11/2008
Last updated
03/11/2008
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