Richard Edward Liske

Individual provider Active NPI Optician · Quitman, TX

NPI 1992120752 · NPPES record last updated Mar 3, 2014

Key facts

NPI
1992120752
Entity type
Individual (NPI type 1)
Primary specialty
Optician 156FX1800X
Practice address
2476 W State Highway 154
Quitman, TX 75783-5587
Phone
(903) 878-2451
Fax
(903) 878-2933
NPI assigned
Mar 3, 2014
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
East Texas Optical, Inc Optician Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X Yes

Addresses

Primary practice location

2476 W State Highway 154
Quitman, TX 75783-5587

Mailing address

2476 W State Highway 154
Quitman, TX 75783-5587
Phone (903) 878-2451

Other providers in Quitman, TX

All providers in Quitman, TX · Optician in Texas

Sources for this page

Verify at the official NPI Registry.