Provider Demographics
NPI:1154888196
Name:OPTIO, PLLC
Entity type:Organization
Organization Name:OPTIO, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOELY
Authorized Official - Middle Name:KATE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-782-6598
Mailing Address - Street 1:2007 IRVING PL
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-2031
Mailing Address - Country:US
Mailing Address - Phone:940-782-6598
Mailing Address - Fax:
Practice Address - Street 1:2211 E SOUTHLAKE BLVD STE 525
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-1533
Practice Address - Country:US
Practice Address - Phone:817-873-6810
Practice Address - Fax:817-766-7026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty