| Texas State Optical | |
|
120 Highway 332 W, Suite A5, Lake Jackson, TX 77566-4017 | |
| (979) 297-3095 | |
| (979) 297-5410 |
| Full Name | Texas State Optical |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 120 Highway 332 W, Lake Jackson, Texas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326262858 | NPI | - | NPPES |
| 161005701 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 5022TG (Texas) | Primary |
| Provider Name | Brian K Shandley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912104969 PECOS PAC ID: 2062406879 Enrollment ID: I20040414000132 |
| Provider Name | Darrin C Shandley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467938878 PECOS PAC ID: 7012251846 Enrollment ID: I20181205003508 |
| Provider Name | Rachael Mcgee |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1851872360 PECOS PAC ID: 3072858364 Enrollment ID: I20181213002941 |
| Mailing Address | Practice Location Address |
|---|---|
| Texas State Optical 120 Highway 332 W, Suite A5, Lake Jackson, TX 77566-4017 Ph: (979) 297-3095 | Texas State Optical 120 Highway 332 W, Suite A5, Lake Jackson, TX 77566-4017 Ph: (979) 297-3095 |
Dr. Julie Nguyen Optometrist Medicare: Not Enrolled in Medicare Practice Location: 121 Highway 332 W, Suite 100, Lake Jackson, TX 77566 Phone: 979-480-9424 Fax: 979-480-9426 | |
Mark A Provenzano Od Optometrist Medicare: Medicare Enrolled Practice Location: 123 Circle Way, Lake Jackson, TX 77566 Phone: 979-299-3250 Fax: 979-299-1724 | |
The Eye Contact, Inc. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 4 W Way Ct, Lake Jackson, TX 77566 Phone: 979-297-3937 Fax: 979-297-9889 | |
Dr. Julie Thuydung Nguyen, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 121 Highway 332 W, 100, Lake Jackson, TX 77566 Phone: 979-480-9424 Fax: 979-480-9426 | |
Robert G. Haws, O.d. P.a. Optometrist Medicare: Medicare Enrolled Practice Location: 126 Oyster Creek Dr Ste A, Lake Jackson, TX 77566 Phone: 979-299-0100 Fax: 979-299-6181 | |
Dr. William Jackson Jr., O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 4 West Way Court, Lake Jackson, TX 77566 Phone: 979-297-3937 Fax: 979-297-9889 |