=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164583415
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RAMA R CARSON OPTOMETRIST
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/12/2006
-----------------------------------------------------
Last Update Date | 11/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2700 SHEPHERD ST
-----------------------------------------------------
City | ABILENE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79605-6752
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 325-313-2224
-----------------------------------------------------
Fax | 325-231-4415
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4310 BUFFALO GAP RD STE 1450
-----------------------------------------------------
City | ABILENE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79606-2762
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 325-692-1627
-----------------------------------------------------
Fax | 325-690-9905
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 6549TG
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------