Provider Demographics
NPI:1598704579
Name:MIDDLETON, OUIDA C (O D)
Entity Type:Individual
Prefix:DR
First Name:OUIDA
Middle Name:C
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-0607
Mailing Address - Country:US
Mailing Address - Phone:281-342-4664
Mailing Address - Fax:281-232-0894
Practice Address - Street 1:4000 AVENUE I
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-3904
Practice Address - Country:US
Practice Address - Phone:281-342-4664
Practice Address - Fax:281-232-0894
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05875TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B7385Medicare ID - Type Unspecified
TXU83790Medicare UPIN