Bronaugh, Charda P

Bronaugh, Charda P is an sole proprietor health care provider with primary practice located at 1607 W Frank Ave Suite 109, Lufkin TX 75904-3103. She recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as her primary health care specialty. Bronaugh, Charda P can be contacted via phone (936) 632-1010.

Contact Information

Primary practice address
1607 W Frank Ave Suite 109 Lufkin TX 75904-3103
Fax: (936) 632-3233
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X

Profile Details

NPI number 1114976420
LBN Legal business name Bronaugh, Charda P
Credentials OPTICIAN
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 6th, 2006
Last updated Dec 15th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114976420 NPPES
Texas MEDICAID 086517201

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