# DR. CHANDRA V. MICKLES

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1831326321
- **Gender:** F
- **Credential:** O.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 8093TG | TX | — |
| 152W00000X | Optometrist | OFC69 | FL | — |
| 152W00000X | Optometrist | T-197-TA-814 | AL | Yes |

## Other

- **Enumeration date:** 06/11/2009
- **Last updated:** 06/30/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 51598855 | BCBS OF ALABAMA | AL |