Trussell L Thane, is a medicare enrolled "Optometrist" provider in Stamford, Texas. His current practice location is
1501 Columbia St, Stamford, Texas. You can reach out to his office (for appointments etc.) via phone at
(325) 773-2083.
Trussell L Thane is licensed to practice in Texas (license number 04720TG) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1609838101.
Healthcare Provider's Profile
Full Name | Trussell L Thane |
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Gender | Male |
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Speciality | Optometrist |
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Location | 1501 Columbia St, Stamford, Texas |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1609838101
- Provider Enumeration Date: 04/03/2006
- Last Update Date: 02/26/2015
Medicare PECOS Information:
- PECOS PAC ID: 0244374759
- Enrollment ID: I20100222000833
Medical Identifiers
Medical identifiers for Trussell L Thane such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1609838101 | NPI | - | NPPES |
126535701 | Medicaid | TX | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
152W00000X | Optometrist | 04720TG (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Trussell L Thane is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Trussell L Thane, 1501 Columbia St, Stamford, TX 79553-6882 Ph: (325) 773-2083 | Trussell L Thane, 1501 Columbia St, Stamford, TX 79553-6882 Ph: (325) 773-2083 |
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