Individual
JERRY L. MCCOMBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
313 MAIN ST, TEAGUE, TX 75860-1621
(254) 739-2020
(254) 739-2244
Mailing address
PO BOX 831, TEAGUE, TX 75860-0831
(254) 739-2020
(254) 739-2244
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02855TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00E50D
BCBS
TX
05
—
093270901
—
TX
Enumeration date
01/19/2006
Last updated
02/05/2008
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