Provider Demographics
NPI:1932119765
Name:CARPENTER, JAMES W JR (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:CARPENTER
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2101 N MIDLAND DR STE 8
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-5593
Mailing Address - Country:US
Mailing Address - Phone:432-689-0901
Mailing Address - Fax:432-689-0191
Practice Address - Street 1:2101 N MIDLAND DR STE 8
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-5593
Practice Address - Country:US
Practice Address - Phone:432-689-0901
Practice Address - Fax:432-689-0191
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3118TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00E55LOtherBCBS
TX140710801Medicaid
TX00E55LMedicare PIN
TX0902990001Medicare NSC