Healthcare Provider Details

I. General information

NPI: 1437914769
Provider Name (Legal Business Name): TEMPLE EYE ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 02/28/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 PALOMA DR
TEMPLE TX
76502-2289
US

IV. Provider business mailing address

221 PALOMA DR
TEMPLE TX
76502-2289
US

V. Phone/Fax

Practice location:
  • Phone: 254-816-2020
  • Fax:
Mailing address:
  • Phone: 254-816-2020
  • 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. THOMAS ALLEN LUCAS JR.
Title or Position: PRESIDENT
Credential: OD
Phone: 254-816-2020