Provider Demographics
NPI:1780671180
Name:APPEL, KEVIN READE (OD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:READE
Last Name:APPEL
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 1:1801 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-3853
Mailing Address - Country:US
Mailing Address - Phone:806-655-7748
Mailing Address - Fax:806-655-2871
Practice Address - Street 1:1801 4TH AVE
Practice Address - Street 2:
Practice Address - City:CANYON
Practice Address - State:TX
Practice Address - Zip Code:79015-3853
Practice Address - Country:US
Practice Address - Phone:806-655-7748
Practice Address - Fax:806-655-2871
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05707TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU75500Medicare UPIN
TX81145EMedicare ID - Type Unspecified