Provider Demographics
NPI:1083767313
Name:TEXAS LONE STAR EYE ASSOCIATES INC
Entity Type:Organization
Organization Name:TEXAS LONE STAR EYE ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDMOND
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:325-692-1627
Mailing Address - Street 1:4310 BUFFALO GAP RD STE 1450
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-2762
Mailing Address - Country:US
Mailing Address - Phone:325-692-1627
Mailing Address - Fax:325-690-9905
Practice Address - Street 1:4310 BUFFALO GAP RD STE 1450
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-2762
Practice Address - Country:US
Practice Address - Phone:325-692-1627
Practice Address - Fax:325-690-9905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6542T152W00000X
TX6549T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty