Provider Demographics
NPI:1326275397
Name:DR. JAMES W. CARPENTER, O.D.
Entity Type:Organization
Organization Name:DR. JAMES W. CARPENTER, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:432-689-0901
Mailing Address - Street 1:2101 N MIDLAND DR STE 8
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-5593
Mailing Address - Country:US
Mailing Address - Phone:432-689-0901
Mailing Address - Fax:432-689-0191
Practice Address - Street 1:2101 N MIDLAND DR STE 8
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-5593
Practice Address - Country:US
Practice Address - Phone:432-689-0901
Practice Address - Fax:432-689-0191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3118TG332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00E55LOtherPTAN
TX0902990001Medicare NSC