Organization
JERRY D REDWINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DONNA JEAN REDWINE (OFFICE MANAGER)
(806) 272-4705
Entity
Organization
Contact information
Practice address
111 E 3RD ST, MULESHOE, TX 79347-3801
(806) 272-4705
(806) 272-3824
Mailing address
PO BOX 1011, MULESHOE, TX 79347-1011
(806) 272-4705
(806) 272-3824
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
2296T
TX
Other
Enumeration date
01/09/2008
Last updated
01/10/2008
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