Organization
LONE STAR OPTICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL BICKELMAN BOREN M.D. (OWNER)
(325) 641-2246
Entity
Organization
Contact information
Practice address
109 S PARK DR, BROWNWOOD, TX 76801-5917
(325) 641-2246
(325) 641-0864
Mailing address
109 S PARK DR, BROWNWOOD, TX 76801-5917
(325) 641-2246
(325) 641-0864
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152777201
—
TX
01
—
81520N
BCBS
TX
Enumeration date
11/15/2006
Last updated
01/26/2012
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