Individual
CHARLES P MCGONAGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1238 N PACIFIC ST, MINEOLA, TX 75773-1002
(903) 569-5432
(903) 569-2994
Mailing address
1238 N PACIFIC ST, MINEOLA, TX 75773-1002
(903) 569-5432
(903) 569-2994
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1785TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00E23A
VISION SERVICE PLAN
TX
01
—
0E23A
SUPERIOR
TX
05
—
164523601
—
TX
01
—
22703
ALWAYS VISION
TX
01
—
23299
WEB-TPA
TX
01
—
2388239
TEXAS TRUE CHOICE
TX
01
—
5451470001
CIGNA GOVERNMENT SERVICES
TX
01
—
5571379
AETNA
TX
01
—
60583
SAFEGUARD
TX
01
—
81257Q
BLUE CROSS BLUE SHIELD
TX
01
—
9933256
CIGNA
TX
Enumeration date
07/07/2005
Last updated
05/19/2011
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