Organization
EAST TEXAS EYE ASSOCIATES
Active
Other names
East Texas Eye Associates Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JO ANN O'NEILL C.O.T. (ADMINISTRATOR)
(936) 634-8381
Entity
Organization
Contact information
Practice address
1306 W FRANK AVE, LUFKIN, TX 75904-3313
(936) 634-8381
(936) 639-9848
Mailing address
1306 W FRANK AVE, LUFKIN, TX 75904-3313
(936) 634-8381
(936) 639-9848
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
210
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127345005
—
TX
01
—
490001072
RAILROAD MEDICARE
TX
01
—
HH1305
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/01/2006
Last updated
03/27/2015
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