Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | 2689TG | TX |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 2689TG | TX |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | 2698TG | TX |
N | 152WP0200X | Pediatric Optomitrist | 2689TG | TX |
N | 152WS0006X | Sports Vision | 2689TG | TX |
N | 152WV0400X | Optomitrist - Vision Therapist | 2689TG | TX |
N | 152WX0102X | Occupational Vision | 2689TG | TX |
NPI | 1275546921 |
---|---|
Provider Name | Dr. Donald Gene Bockin |
First Address | Harker Heights, TX 76548-6020 |
Second Address | Harker Heights, TX 76548-6020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
74186705265410000 | TRICARE (01) | TX |
T12256 | (02) | TX |