Provider Demographics
NPI:1477020980
Name:TEXAS STELLAR OPTOMETRY
Entity Type:Organization
Organization Name:TEXAS STELLAR OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:HASSETT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:817-975-6848
Mailing Address - Street 1:10448 STONESIDE TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-6372
Mailing Address - Country:US
Mailing Address - Phone:817-975-6848
Mailing Address - Fax:
Practice Address - Street 1:1607 W HENDERSON ST
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-4188
Practice Address - Country:US
Practice Address - Phone:817-645-7733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty