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Individual

DR. CHARLES COLLARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
106 NACOGDOCHES ST, CENTER, TX 75935-3852
(936) 591-0808
Mailing address
106 NACOGDOCHES ST, CENTER, TX 75935-3852

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5053TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P0043300082659
RAILROAD MEDICARE
Enumeration date
11/15/2006
Last updated
10/01/2012
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