Provider Demographics
NPI:1972804169
Name:LONE STAR EYE PLLC
Entity type:Organization
Organization Name:LONE STAR EYE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:PACKER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:512-328-7300
Mailing Address - Street 1:2700 BARTON CREEK BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-1641
Mailing Address - Country:US
Mailing Address - Phone:512-328-7300
Mailing Address - Fax:512-328-7303
Practice Address - Street 1:2700 BARTON CREEK BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-1641
Practice Address - Country:US
Practice Address - Phone:512-328-7300
Practice Address - Fax:512-328-7303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7577TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7577TGOtherTEXAS OPTOMETRY LICENSE