MEDICARE: DR. KAREN EBLING OGLESBY O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	5801TG	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	U84439	OTHER	TX	LEGACY MEDICARE UPIN 2001 - 2012
3	8C0860	OTHER	TX	LEGACY MEDICARE PTAN 2001-2012

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144223637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN EBLING OGLESBY O.D.

Provider Business Mailing Address
First Line	:	5001 BISSONNET ST STE 107
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77401-4015
Country	:	US
Telephone Number	:	713-664-8087
Fax Number	:	713-664-8078

Provider Business Practice Location Address
First Line	:	5001 BISSONNET ST STE 107
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77401-4015
Country	:	US
Telephone Number	:	713-664-8087
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	01/27/2022

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