Provider Demographics
NPI:1306024401
Name:GARY CLOUD, O.D., , P.C.
Entity Type:Organization
Organization Name:GARY CLOUD, O.D., , P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOUD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:361-664-2020
Mailing Address - Street 1:559 HWY. 281 N.
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-7801
Mailing Address - Country:US
Mailing Address - Phone:361-664-2020
Mailing Address - Fax:361-664-7852
Practice Address - Street 1:559 HWY. 281 N.
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-7801
Practice Address - Country:US
Practice Address - Phone:361-664-2020
Practice Address - Fax:361-664-7852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT12699Medicare UPIN
TX0640870001Medicare NSC