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General NPI Number Information
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NPI Number | 1144389842
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Entity Type | Organization
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Legal Business Name | SOUTHEAST TEXAS EYE ASSOCIATES
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 521 S 10TH ST
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City | MCALLEN
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State | TX
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Zip | 78501-4949
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Country | US
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Telephone | 956-631-1951
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Fax | 956-683-1625
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Provider Business Mailing Address
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Address Line | 521 S 10TH ST
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City | MCALLEN
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State | TX
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Zip | 78501-4949
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Country | US
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Telephone | 956-631-1951
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Fax | 956-683-1625
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Authorized Official
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Title or Position | DOCTOR
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Name | RICHARD GILLETT
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Credential | M.D
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Telephone | 956-631-1951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | H8656
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License Number State | TX
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