Provider Demographics
NPI:1407985880
Name:KNOWLES, CHARLES ALEXANDER (OD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ALEXANDER
Last Name:KNOWLES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:CALEX
Other - Middle Name:
Other - Last Name:KNOWLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:309 S OAKLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76103-3762
Mailing Address - Country:US
Mailing Address - Phone:817-536-9970
Mailing Address - Fax:817-531-2534
Practice Address - Street 1:309 S OAKLAND BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76103-3762
Practice Address - Country:US
Practice Address - Phone:817-536-9970
Practice Address - Fax:817-531-2534
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3132T152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management