Provider Demographics
NPI:1235284159
Name:SUMERLIN, LARRY DEL (OD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:DEL
Last Name:SUMERLIN
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 1:2000 S EXPRESSWAY 83
Mailing Address - Street 2:STE B-05
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-5950
Mailing Address - Country:US
Mailing Address - Phone:956-412-7775
Mailing Address - Fax:956-412-7776
Practice Address - Street 1:2000 S EXPRESSWAY 83
Practice Address - Street 2:STE B-05
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-5950
Practice Address - Country:US
Practice Address - Phone:956-412-7775
Practice Address - Fax:956-412-7776
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2642152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU11933Medicare UPIN
TX00E76LMedicare ID - Type Unspecified