Organization
CHARLES L. HEATON, MD, PA
Active
Other names
Heaton Eye Associates Optical Shop
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH HODGES-ODOM (CREDENTIALING SPECIALIST)
(903) 526-0444
Entity
Organization
Contact information
Practice address
1205 N 6TH ST, LONGVIEW, TX 75601-5539
(903) 234-0771
(903) 234-0775
Mailing address
3415 GOLDEN RD, TYLER, TX 75701-8355
(903) 526-0444
(903) 526-2051
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
01/12/2011
Last updated
08/09/2023
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