Provider Demographics
NPI:1639282593
Name:RAND, CHRISTOPHER RANDALL (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:RANDALL
Last Name:RAND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:801 MCCLINTIC DR
Mailing Address - Street 2:
Mailing Address - City:GROESBECK
Mailing Address - State:TX
Mailing Address - Zip Code:76642-2130
Mailing Address - Country:US
Mailing Address - Phone:254-729-4323
Mailing Address - Fax:254-729-4327
Practice Address - Street 1:801 MCCLINTIC DR
Practice Address - Street 2:
Practice Address - City:GROESBECK
Practice Address - State:TX
Practice Address - Zip Code:76642-2130
Practice Address - Country:US
Practice Address - Phone:254-729-3411
Practice Address - Fax:254-729-3258
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6323TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163735701Medicaid
TX80851QOtherBC/BS
TXU93611Medicare UPIN
TX8A2911Medicare PIN
TX163735701Medicaid