Provider Demographics
NPI:1871241935
Name:LIN, STEVEN (OD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 CHERRYSTONE CIR
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-3074
Mailing Address - Country:US
Mailing Address - Phone:361-237-8229
Mailing Address - Fax:
Practice Address - Street 1:8306 N NAVARRO ST STE B
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-2600
Practice Address - Country:US
Practice Address - Phone:361-573-4884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10313T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist