MEDICARE: DR. EDMOND J CARSON OPTOMETRIST

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	6542T	TX

General Provider Information

NPI Number	:	1407916372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDMOND J CARSON OPTOMETRIST

Provider Business Mailing Address
First Line	:	566 E AMBLER AVE
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79601-2516
Country	:	US
Telephone Number	:	325-313-2224
Fax Number	:	325-231-4415

Provider Business Practice Location Address
First Line	:	566 E AMBLER AVE
Second Line	:
City	:	ABILENE
State	:	TX
Zip	:	79601-2516
Country	:	US
Telephone Number	:	325-313-2224
Fax Number	:

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

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	04/15/2026

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