Funkhouser Opticians
Organization Active NPI Eyewear Supplier · Athens, TX
NPI 1265617336 · NPPES record last updated May 21, 2008
Key facts
- NPI
- 1265617336
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Eyewear Supplier 332H00000X
- Legal business name
- FUNKHOUSER OPTICIANS
- Practice address
- 1206 S Palestine St
Athens, TX 75751-3619 - Phone
- (903) 677-1985
- Fax
- (903) 677-2099
- NPI assigned
- Jan 8, 2008
- Organization subpart
- No
Authorized official
- Name
- Leslie Melvin Funkhouser
- Title
- Owner
- Phone
- (903) 677-1985
Practitioners 1
-
Leslie M Funkhouser, OPTICIAN
National Provider Directory
Locations
1206 S Palestine St
Athens, TX 75751
Phone (903) 292-1774
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Eyewear Supplier | 332H00000X | Yes |
Addresses
Primary practice location
1206 S Palestine St
Athens, TX 75751-3619
Mailing address
PO Box 952
Athens, TX 75751-0952
Phone (903) 677-1985
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 528354 | Other | BCBS OF TX | |
| 066298301 | Medicaid | TX | |
| 149257101 | Medicaid | TX |
Other providers in Athens, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.