Provider Demographics
NPI:1902824337
Name:MCGUIRE, ROBERT ELLIOTT (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ELLIOTT
Last Name:MCGUIRE
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:PO BOX 5163
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79704-5163
Mailing Address - Country:US
Mailing Address - Phone:432-699-2596
Mailing Address - Fax:
Practice Address - Street 1:2706 W CUTHBERT
Practice Address - Street 2:BUILDING A
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701
Practice Address - Country:US
Practice Address - Phone:432-694-0999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2736TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00371ZMedicare ID - Type Unspecified
T14737Medicare UPIN