Healthcare Provider Details
I. General information
NPI: 1053494245
Provider Name (Legal Business Name): THE CENTER FOR SIGHT, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/23/2006
Last Update Date: 12/29/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2 MEDICAL CENTER BLVD
LUFKIN TX
75904-3173
US
IV. Provider business mailing address
2 MEDICAL CENTER BLVD
LUFKIN TX
75904-3173
US
V. Phone/Fax
- Phone: 936-634-8434
- Fax: 936-639-2581
- Phone: 936-634-8434
- Fax: 936-639-2581
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RICHARD
J
RUCKMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 936-634-8434