Organization
JERRAD SCOTT MILLS
Active
Other names
Deer Park Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNIE THAXTON (OFFICE MANAGER)
(281) 479-4570
Entity
Organization
Contact information
Practice address
2009 CENTER ST, DEER PARK, TX 77536-4161
(281) 479-4570
Mailing address
2009 CENTER ST, DEER PARK, TX 77536-4161
(281) 479-4570
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
02082
TX
152W00000X
Optometrist
Primary
6368TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0042PP
BLUE CROSS BLUE SHIELD
TX
01
—
1104829464
NPI
TX
Enumeration date
03/20/2007
Last updated
09/03/2008
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