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Individual
TOM RAY MCCLINTOCK
Active
Individual
TOM RAY MCCLINTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4516TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00E41Y
MEDICARE GROUP PIN
TX
01
—
1234530001
DMERC
TX
01
—
1326062449
NPI
TX
01
—
1902852346
GROUP NPI
TX
01
—
752711435
GROUP TAX ID
TX
01
—
L0118195
DPS
TX
Enumeration date
07/26/2006
Last updated
03/07/2023
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