Provider Demographics
NPI:1326232117
Name:JOHN A. CARTER, JR., O.D., P.A.
Entity Type:Organization
Organization Name:JOHN A. CARTER, JR., O.D., P.A.
Other - Org Name:BONHAM OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ALFRED
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:903-583-8930
Mailing Address - Street 1:1230 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:BONHAM
Mailing Address - State:TX
Mailing Address - Zip Code:75418-3016
Mailing Address - Country:US
Mailing Address - Phone:903-583-8930
Mailing Address - Fax:903-583-8138
Practice Address - Street 1:1230 N CENTER ST
Practice Address - Street 2:
Practice Address - City:BONHAM
Practice Address - State:TX
Practice Address - Zip Code:75418-3016
Practice Address - Country:US
Practice Address - Phone:903-583-8930
Practice Address - Fax:903-583-8138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5381TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00E96VOtherMEDICARE NUMBER
TX1234710001OtherPALMETTO
TXU66508Medicare UPIN