Childress Vision Clinic

Primary specialty

OptometristTaxonomy code 152W00000X

License

1892 Issued in TX

Legal business name

CHILDRESS VISION CLINIC

Practice address

408 E Magrill St
Longview, TX 75601-6444

Phone

(903) 753-4436

Fax

(903) 757-4400

NPI assigned

Jan 28, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Carl Wayne Childress, O.D.NPI 1801902606

Title

Owner

Phone

(903) 753-4436

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carl W Childress, O.D.

  • Sports Vision Optometrist
  • Longview, TX
  • NPI 1801902606

  Corneal and Contact Management

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201737600000",
    "number": "1104003581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 E MAGRILL ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756016444",
            "telephone_number": "903-753-4436",
            "fax_number": "903-757-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 E MAGRILL ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756016444",
            "telephone_number": "903-753-4436",
            "fax_number": "903-757-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRESS VISION CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-31",
        "status": "A",
        "authorized_official_last_name": "CHILDRESS",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-753-4436",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "1892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Ray Chen, M.D.
• Jessica Cheshier, LPC
• CHG Senior Living of Longview, LLC
• Philip John Chifulio, LCDC
• Anthonia Chigbo
• Alicia Childress, LCDC
• Carl W Childress, O.D.
• Laura Childress, RN, MSN, WHNP
• Madhu Chiluveri, MD
• Courtney Brooks Chism, DO

• All providers in Longview, TX
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.