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Individual

BEN B DONALD II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
403 N ADAMS ST, CARTHAGE, TX 75633-1311
(903) 694-2300
(903) 694-2333
Mailing address
403 N ADAMS ST, CARTHAGE, TX 75633
(903) 694-2300
(903) 694-2333

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4453TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
019346801
TX
01
0540180001
CIGNA GOVERNMENT SERVICES
01
14867
SPECTERA PIN
01
924329
BLOCK VISION
Enumeration date
10/05/2006
Last updated
02/19/2008
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