Provider Demographics
NPI:1972509461
Name:ERMIS, KARL MICHAEL (OD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:MICHAEL
Last Name:ERMIS
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 1:2012 W LOOP ST
Mailing Address - Street 2:
Mailing Address - City:EL CAMPO
Mailing Address - State:TX
Mailing Address - Zip Code:77437-8030
Mailing Address - Country:US
Mailing Address - Phone:979-543-6821
Mailing Address - Fax:979-543-6817
Practice Address - Street 1:2012 W LOOP ST
Practice Address - Street 2:
Practice Address - City:EL CAMPO
Practice Address - State:TX
Practice Address - Zip Code:77437-8030
Practice Address - Country:US
Practice Address - Phone:979-543-6821
Practice Address - Fax:979-543-6817
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4459TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131011207Medicaid
P00038685Medicare PIN
TX8A7665Medicare ID - Type Unspecified
U32050Medicare UPIN