Organization
OAK CREEK OPTICAL
Active
Other names
Richard D. Grossnickle, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. A LISA GROSSNICKLE (OFFICE MANAGER)
(903) 785-0443
Entity
Organization
Contact information
Practice address
2615 NE LOOP 286, PARIS, TX 75460-3444
(903) 785-0443
(903) 785-2947
Mailing address
2615 NE LOOP 286, PARIS, TX 75460-3444
(903) 785-0443
(903) 785-2947
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
E6388
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1100976-02
—
TX
Enumeration date
01/18/2008
Last updated
03/10/2008
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