Healthcare Provider Details

I. General information

NPI: 1881348258
Provider Name (Legal Business Name): LONE STAR FAMILY EYE CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2022
Last Update Date: 06/14/2022
Certification Date: 06/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11700 US HIGHWAY 380
CROSSROADS TX
76227-8200
US

IV. Provider business mailing address

11700 US HIGHWAY 380
CROSSROADS TX
76227-8200
US

V. Phone/Fax

Practice location:
  • Phone: 940-488-5133
  • Fax: 940-218-9001
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHAN EDWARD HEBDA
Title or Position: OWNER
Credential: OD
Phone: 214-538-6511