MEDICARE: WILLIAM KORAEN POPE 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	4047	AR
2	152W00000X	Optometrist	5010TG	TX
3	152W00000X	Optometrist	OPC6831	FL
4	152W00000X	Optometrist	OPT-2026-0006	NM
5	152W00000X	Optometrist	5010T	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	410040981	OTHER	TX	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1588744973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM KORAEN POPE O.D.

Provider Business Mailing Address
First Line	:	711 E GOLIAD AVE
Second Line	:
City	:	CROCKETT
State	:	TX
Zip	:	75835-2140
Country	:	US
Telephone Number	:	936-544-3763
Fax Number	:	936-544-7894

Provider Business Practice Location Address
First Line	:	711 E GOLIAD AVE
Second Line	:
City	:	CROCKETT
State	:	TX
Zip	:	75835-2140
Country	:	US
Telephone Number	:	936-544-3763
Fax Number	:	936-544-7894

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	05/05/2026

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Directions to “ WILLIAM KORAEN POPE O.D.” Practice Location

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