Provider Demographics
NPI:1437509700
Name:VOIGT, KEVIN WAYNE (OD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:WAYNE
Last Name:VOIGT
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 1:5729 ESPLANADE DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4138
Mailing Address - Country:US
Mailing Address - Phone:361-991-3800
Mailing Address - Fax:361-991-6510
Practice Address - Street 1:5729 ESPLANADE DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4138
Practice Address - Country:US
Practice Address - Phone:361-991-3800
Practice Address - Fax:361-991-6510
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8903TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX361472901Medicaid
TX8903TGOtherLICENSE