Provider Demographics
NPI:1568468585
Name:GOLDEN, DAVID DIXON (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:DIXON
Last Name:GOLDEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1838
Mailing Address - Street 2:
Mailing Address - City:CENTER
Mailing Address - State:TX
Mailing Address - Zip Code:75935-1838
Mailing Address - Country:US
Mailing Address - Phone:936-598-8501
Mailing Address - Fax:936-598-2311
Practice Address - Street 1:702 LOUISIANA ST
Practice Address - Street 2:
Practice Address - City:CENTER
Practice Address - State:TX
Practice Address - Zip Code:75935-3672
Practice Address - Country:US
Practice Address - Phone:936-598-8501
Practice Address - Fax:936-598-2311
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2494TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112471102Medicaid
TX112471102Medicaid
TXT13495Medicare UPIN