Organization
RETINA CENTER P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK PETER KUHL M.D., PH D (OWNER)
(979) 776-8330
Entity
Organization
Contact information
Practice address
2806 E 29TH ST, BRYAN, TX 77802-2601
(979) 776-8330
(979) 774-9157
Mailing address
2806 E 29TH ST, BRYAN, TX 77802-2601
(979) 776-8330
(979) 774-9157
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
L2390
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165691001
—
TX
01
—
DC0989
MEDICARE RAILROAD
TX
Enumeration date
07/11/2005
Last updated
08/14/2012
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