DR. CARL W CHILDRESS O.D. NPI 1801902606

NPI Information

NPI: 1801902606
Provider Name: DR. CARL W CHILDRESS, O.D.
Classification: Optometrist - 152WC0802X
Entity Type: Individual

Specialization: Corneal and Contact Management

PECOS Registration: Yes

Address:
408 E MAGRILL ST
LONGVIEW, TX
ZIP 75601
Phone: (903) 753-4436
Get Directions

DR. Carl W Childress, O.D. is a corneal and contact management optometrist in Longview, TX. The provider is the professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. DR. Carl W Childress, O.D. NPI is 1801902606. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

408 E MAGRILL ST
LONGVIEW, TX
ZIP 75601-444
Phone: (903) 753-4436
Fax: (903) 757-4400

The NPI 1801902606 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 8/22/2006 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	152WC0802X	Optometrist	Corneal and Contact Management	1892	TEXAS	Yes
2	152WL0500X	Optometrist	Low Vision Rehabilitation	1892	TEXAS	X
3	152WP0200X	Optometrist	Pediatrics	1892	TEXAS	X
4	152WS0006X	Optometrist	Sports Vision	1892	TEXAS	X
5	152WV0400X	Optometrist	Vision Therapy	1892	TEXAS	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	T12634	MEDICARE UPIN	TEXAS
2	00E14J	MEDICARE PIN	TEXAS
3	505835	MEDICARE ID-TYPE UNSPECIFIED	TEXAS	GRP #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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