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NPI Code Detail

MEDICARE: DR. DONALD R. MIGL O.D.

MEDICARE: DR. DONALD R. MIGL 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
1152W00000XOptometrist2796TTX

General Provider Information

NPI Number : 1336289396
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONALD R. MIGL O.D.
Provider Business Mailing Address
First Line : 3610 COLONY CREEK DR
Second Line :
City : NACOGDOCHES
State : TX
Zip : 75965-6976
Country : US
Telephone Number : 936-560-5250
Fax Number :
Provider Business Practice Location Address
First Line : 4810 NORTH ST STE 2020
Second Line :
City : NACOGDOCHES
State : TX
Zip : 75965-1876
Country : US
Telephone Number : 936-568-0219
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 07/08/2007

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