NPI:
1396798955
Provider Name:
LYLE THORSTENSON, MD
Other Name: THORSTENSON EYE CLINIC, OPTICAL, ASC
Classification:
Clinic/Center - 261QS0132X
Entity Type:
Organization
Specialization: Ophthalmologic Surgery
Address:
3302 NE STALLINGS DR
NACOGDOCHES, TX
ZIP 75965
Phone:
(936) 564-2411
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LYLE THORSTENSON, MD is an ophthalmologic surgery clinic center in Nacogdoches, TX. LYLE THORSTENSON, MD NPI is 1396798955. The provider is registered as an organization entity type.
The provider Other Name Is Thorstenson Eye Clinic, Optical, Asc.
The provider's business location address is:
3302 NE STALLINGS DR
NACOGDOCHES, TX
ZIP 75965-727
Phone: (936) 564-2411
Fax: (936) 564-1280
The provider's authorized official is Lyle S Thorstenson .
The authorized official title is Owner/physician and has the following contact phone number (936) 564-2411.
The enumeration date for this NPI number is 5/17/2006 and was last updated on 10/4/2007.