Provider Demographics
NPI:1184711665
Name:MCPHERSON, SCOTT (OD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:MCPHERSON
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 1:5402 66TH ST
Mailing Address - Street 2:APT.1122
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-1313
Mailing Address - Country:US
Mailing Address - Phone:806-283-1536
Mailing Address - Fax:
Practice Address - Street 1:4217 S LOOP 289
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1100
Practice Address - Country:US
Practice Address - Phone:806-793-3309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6677T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0011FFOtherBLUE CROSS BLUE SHIELD
TX454332OtherNATIONAL VISION
TXMC1676322OtherCLARITY VISION
TX19640OtherCOAST-TO-COAST VISION
TX11455894OtherGREAT WEST HEALTH
TX25520OtherSPECTERA