Organization
LIFESTYLE VISION CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN B. MOORE OD (OWNER)
(936) 327-6379
Entity
Organization
Contact information
Practice address
1618 W CHURCH ST, LIVINGSTON, TX 77351-9043
(936) 327-6379
Mailing address
1618 W CHURCH ST, LIVINGSTON, TX 77351-9043
(936) 327-6379
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007955602
AETNA
TX
01
—
12709
SPECTERA
TX
01
—
22728
AVESIS
TX
01
—
28457
MEDICAL EYE SERVICES
TX
01
—
29FF
BLUE CROSS BLUE SHIELD
TX
01
—
30222
OPTICARE
TX
01
—
47746
DAVIS VISION
TX
01
—
560275
NATIONAL VISION ADMINISTR
TX
01
—
930767
BLOCK INSURANCE
TX
01
—
U157848
STERLING
TX
Enumeration date
03/30/2007
Last updated
08/22/2020
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