MEDICARE: CHRISTINE ENGLISH OCONNOR OD

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	04641TG	TX

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	:	1497792246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE ENGLISH OCONNOR OD

Provider Business Mailing Address
First Line	:	3501 SONCY RD
Second Line	:	STE 100
City	:	AMARILLO
State	:	TX
Zip	:	79119-6405
Country	:	US
Telephone Number	:	806-352-3157
Fax Number	:	806-358-0041

Provider Business Practice Location Address
First Line	:	3501 SONCY RD
Second Line	:	STE 100
City	:	AMARILLO
State	:	TX
Zip	:	79119-6405
Country	:	US
Telephone Number	:	806-352-3157
Fax Number	:	806-358-0041

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

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	04/22/2013

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