Organization
CHILDRESS VISION CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL WAYNE CHILDRESS O.D. (OWNER)
(903) 753-4436
Entity
Organization
Contact information
Practice address
408 E MAGRILL ST, LONGVIEW, TX 75601-6444
(903) 753-4436
(903) 757-4400
Mailing address
408 E MAGRILL ST, LONGVIEW, TX 75601-6444
(903) 753-4436
(903) 757-4400
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1892
TX
Other
Enumeration date
01/28/2008
Last updated
01/31/2008
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