Lyle Thorstenson, MD

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

License

F2064 Issued in TX

Legal business name

LYLE THORSTENSON, MD

Practice address

3302 NE Stallings Dr
Nacogdoches, TX 75965-8727

Phone

(936) 564-2411

Fax

(936) 564-1280

NPI assigned

May 17, 2006

Last updated

Oct 4, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lyle S Thorstenson, M.D.

Title

Owner/Physician

Phone

(936) 564-2411

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Thorstenson Eye Clinic, Optical, ASC Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1396798955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632020",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759632020",
            "telephone_number": "936-564-2411",
            "fax_number": "936-564-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3302 NE STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759658727",
            "telephone_number": "936-564-2411",
            "fax_number": "936-564-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYLE THORSTENSON, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "THORSTENSON",
        "authorized_official_first_name": "LYLE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "936-564-2411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "TX",
            "license": "F2064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "451159",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P000HH693",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "451159",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Thorstenson Eye Clinic, Optical, ASC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• David Allen Luquette, DC
• Shannon Marie Lutz, PT
• Lyle L. Brown MD PA
• Lyle Thorstenson MD (Thorstenson Eye Clinic Surgery Center)
• Lyle Thorstenson MD (Thorstenson Eye Clinic Optical)
• Patricia Self Lynch, MA, LPC
• Malcolm Kent Lyon, DO
• M & S Pharmacy, Inc. (M & S Pharmacy)
• M & S Pharmacy, Inc.
• Veronica Macias

• Ophthalmologic Surgery Clinic/Center in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Ophthalmologic Surgery Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.