Organization
LYLE THORSTENSON MD
Active
Other names
Thorstenson Eye Clinic Optical
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA R THORSTENSON (ADMINISTRATOR)
(936) 564-2411
Entity
Organization
Contact information
Practice address
3302 NE STALLINGS DR, NACOGDOCHES, TX 75965-8727
(936) 564-2411
(936) 564-1280
Mailing address
PO BOX 632020, NACOGDOCHES, TX 75963-2020
(936) 564-2411
(936) 564-1280
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
08/23/2006
Last updated
08/22/2020
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