Organization
EAST TEXAS OPTICAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD EDWARD LISKE (PRESIDENT)
(903) 878-2451
Entity
Organization
Contact information
Practice address
2476 W STATE HIGHWAY 154, QUITMAN, TX 75783-5587
(903) 878-2451
(903) 878-2933
Mailing address
PO BOX 49, QUITMAN, TX 75783-0049
(903) 878-2451
(902) 878-2933
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
03/15/2007
Last updated
08/22/2020
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