Provider Demographics
NPI:1346315082
Name:DR D H MCGONAGILL, INC
Entity Type:Organization
Organization Name:DR D H MCGONAGILL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:H
Authorized Official - Last Name:MCGONAGILL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:432-267-7601
Mailing Address - Street 1:109 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BIG SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:79720-2507
Mailing Address - Country:US
Mailing Address - Phone:432-267-7601
Mailing Address - Fax:432-267-4838
Practice Address - Street 1:109 E 3RD ST
Practice Address - Street 2:
Practice Address - City:BIG SPRING
Practice Address - State:TX
Practice Address - Zip Code:79720-2507
Practice Address - Country:US
Practice Address - Phone:432-267-7601
Practice Address - Fax:432-267-4838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1366152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOOE9OJMedicare ID - Type Unspecified
TXT14732Medicare UPIN