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General NPI Number Information
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NPI Number | 1629915418
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Entity Type | Organization
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Legal Business Name | EAST TEXAS LIGHTHOUSE FOR THE BLIND
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Dates
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Enumeration Date | 04/30/2026
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Last Update Date | 04/30/2026
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Provider Practice Location Address
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Address Line | 411 W FRONT ST
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City | TYLER
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State | TX
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Zip | 75702-8026
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Country | US
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Telephone | 903-593-3111
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Fax |
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Provider Business Mailing Address
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Address Line | 411 W FRONT ST
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City | TYLER
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State | TX
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Zip | 75702-8026
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Country | US
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Telephone | 903-593-3111
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT/CHIEF MISSION OFFIC
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Name | ALICIA LANSFORD
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Credential |
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Telephone | 903-593-3111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225CX0006X
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Taxonomy Name | Orientation and Mobility Training Rehabilitation Counselor
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License Number |
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License Number State |
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