Healthcare Provider Details

I. General information

NPI: 1427420496
Provider Name (Legal Business Name): LEHMANN EYE CENTER OF JASPER, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2015
Last Update Date: 02/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 WEST GIBSON
JASPER TX
75951-4977
US

IV. Provider business mailing address

103 WEST GIBSON
JASPER TX
75951-4977
US

V. Phone/Fax

Practice location:
  • Phone: 409-381-8100
  • Fax: 409-381-8101
Mailing address:
  • Phone: 409-381-8100
  • Fax: 409-381-8101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOYCE E GREER
Title or Position: ADMINISTRATOR
Credential:
Phone: 936-569-8278