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General NPI Number Information
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NPI Number | 1871686055
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Entity Type | Individual
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Provider Name | SANDRA L EASTER OD
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 610 N TWNEAST BLVD STE 100
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City | MESQUITE
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State | TX
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Zip | 75150-4705
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Country | US
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Telephone | 972-279-2020
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Fax | 972-279-2637
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Provider Business Mailing Address
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Address Line | 8614 WESTWOOD CENTER DR FL 9
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City | VIENNA
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State | VA
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Zip | 22182-2442
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Country | US
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Telephone | 972-279-2020
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Fax | 972-279-2637
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | KS1547
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5699
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License Number State | TX
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