Provider Demographics
NPI:1427043884
Name:UPCHURCH, ALAN H (OD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:H
Last Name:UPCHURCH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 W ELDORADO PKWY
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-4229
Mailing Address - Country:US
Mailing Address - Phone:972-542-0331
Mailing Address - Fax:972-548-1102
Practice Address - Street 1:3705 W ELDORADO PKWY
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-4229
Practice Address - Country:US
Practice Address - Phone:972-542-0331
Practice Address - Fax:972-548-1102
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1144152WC0802X
TX3701-TG152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0191800001Medicare NSC
TXTXB152141Medicare PIN
TXT16373Medicare UPIN