Organization Active NPI

Richard B Culbert MD PA

Doing business as Premier Retina Specialists

  • Retina Specialist (Ophthalmology) Physician
  • Midland, TX
National Provider Identifier
1962450668
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X
Legal business name
RICHARD B CULBERT MD PA
Doing business as
Premier Retina Specialists
Practice address
10100 Loop 40
Midland, TX 79706-2205
Phone
(432) 332-2682
Fax
(432) 582-2557
NPI assigned
May 4, 2006
Last updated
Mar 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Authorized official

Name
Luan Holdridge, BBA
Title
Practice Manager
Phone
(432) 617-0181

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X
Retina Specialist (Ophthalmology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207WX0107X Primary

Addresses

Primary practice location

10100 Loop 40
Midland, TX 79706-2205

Mailing address

PO Box 61880
Midland, TX 79711-1880
Phone (432) 617-0181

Other identifiers 1

IdentifierTypeStateIssuer
166712301MedicaidTX

Other names 1

  • Premier Retina Specialists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040525001098 TX Part B Supplier - Clinic/Group Practice 4981685195 Receives reassigned benefits from 3 practitioners
Practice locations: Ft Stockton, TX; Midland, TX; Pecos, TX; San Angelo, TX

National Provider Directory

National Provider Directory

Locations

603 N Main St
Fort Stockton, TX 79735
Phone (432) 336-3662

10100 Loop 40
Midland, TX 79706
Phone (432) 617-0181

155 SE Loop 338
Ste 200
Odessa, TX 79762
Phone (432) 339-0155

840 Central Dr
Odessa, TX 79761
Phone (432) 332-2682

3542 Loop 306
Bldg A
San Angelo, TX 76904
Phone (325) 653-0118

Interoperability endpoints

  • Direct secure messaging: gescobedo@drsprs.drsdocdirect.com

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1962450668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61880",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797111880",
            "telephone_number": "432-617-0181",
            "fax_number": "432-563-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 LOOP 40",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797062205",
            "telephone_number": "432-332-2682",
            "fax_number": "432-582-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD B CULBERT MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "HOLDRIDGE",
        "authorized_official_first_name": "LUAN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "432-617-0181",
        "authorized_official_credential": "BBA"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Retina Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166712301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Retina Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.