Provider Demographics
NPI:1346455011
Name:DR. CLYDE SINGLETON OD PA
Entity Type:Organization
Organization Name:DR. CLYDE SINGLETON OD PA
Other - Org Name:DR SINGLETON AND ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLYDE
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGLETON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-732-3200
Mailing Address - Street 1:1603 VANCE JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-4470
Mailing Address - Country:US
Mailing Address - Phone:210-732-3200
Mailing Address - Fax:210-731-9089
Practice Address - Street 1:27615 AUTUMN TERRACE
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006
Practice Address - Country:US
Practice Address - Phone:210-732-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6851T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty