Provider Demographics
NPI:1053505891
Name:GIDDINGS EYE CARE PLLC
Entity Type:Organization
Organization Name:GIDDINGS EYE CARE PLLC
Other - Org Name:GIDDINGS EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:RANDOLPH
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-542-2020
Mailing Address - Street 1:2480 E AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:GIDDINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78942-3636
Mailing Address - Country:US
Mailing Address - Phone:979-542-2020
Mailing Address - Fax:979-542-1213
Practice Address - Street 1:2480 E AUSTIN ST
Practice Address - Street 2:
Practice Address - City:GIDDINGS
Practice Address - State:TX
Practice Address - Zip Code:78942-3636
Practice Address - Country:US
Practice Address - Phone:979-542-2020
Practice Address - Fax:979-542-1213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207W00000X
TX332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149067401Medicaid
TX00126SOtherMEDICARE GROUP
TX0031FAOtherBLUE CROSS BLUE SHIELD
TXDB0442OtherMEDICARE RAILROAD
TX00126SOtherMEDICARE GROUP