Provider Demographics
NPI:1144210592
Name:TWAMLEY, CHRISTIAN (OD)
Entity Type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:
Last Name:TWAMLEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4605 S COOPER ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-5827
Mailing Address - Country:US
Mailing Address - Phone:817-557-9595
Mailing Address - Fax:817-465-1778
Practice Address - Street 1:4605 S COOPER ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5827
Practice Address - Country:US
Practice Address - Phone:817-557-9595
Practice Address - Fax:817-465-1778
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05462TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163454502Medicaid
TX8B1331Medicare ID - Type Unspecified