Trussell Thane OD

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

4720TG Issued in TX

Legal business name

TRUSSELL THANE OD

Practice address

1501 Columbia St
Stamford, TX 79553-6832

Phone

(325) 773-2083

Fax

(325) 773-2526

NPI assigned

Mar 11, 2008

Organization subpart

No

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

Authorized official

Name

Katrina L Thane

Title

Manager

Phone

(325) 773-2083

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1427228964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 COLUMBIA ST",
            "city": "STAMFORD",
            "state": "TX",
            "postal_code": "795536832",
            "telephone_number": "325-773-2083",
            "fax_number": "325-773-2526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 COLUMBIA ST",
            "city": "STAMFORD",
            "state": "TX",
            "postal_code": "795536832",
            "telephone_number": "325-773-2083",
            "fax_number": "325-773-2526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUSSELL THANE OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "THANE",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "325-773-2083"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "TX",
            "license": "4720TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in Stamford, TX
• Providers in Stamford, TX by specialty
• Eyewear Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.