Elza Leroy Kutch, OD
Individual provider Active NPI Optometrist · Caldwell, TX
NPI 1285784397 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1285784397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1823 (TX)
- Practice address
- 3431 County Rd 330
Caldwell, TX 77836 - Phone
- (979) 567-3420
- NPI assigned
- Jan 11, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1823 | TX | MD | Optometrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1823 | TX | Yes |
Addresses
Primary practice location
3431 County Rd 330
Caldwell, TX 77836
Mailing address
PO Box 334
Caldwell, TX 77836
Phone (979) 567-3420
Other providers in Caldwell, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.