Provider Demographics
NPI:1124148705
Name:DAVID DIXON GOLDEN, OD, PA
Entity type:Organization
Organization Name:DAVID DIXON GOLDEN, OD, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:DIXON
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:936-598-8501
Mailing Address - Street 1:702 LOUISIANA ST
Mailing Address - Street 2:P. O. BOX 1838
Mailing Address - City:CENTER
Mailing Address - State:TX
Mailing Address - Zip Code:75935-3672
Mailing Address - Country:US
Mailing Address - Phone:936-598-8501
Mailing Address - Fax:936-598-2311
Practice Address - Street 1:702 LOUISIANA ST
Practice Address - Street 2:
Practice Address - City:CENTER
Practice Address - State:TX
Practice Address - Zip Code:75935-3672
Practice Address - Country:US
Practice Address - Phone:936-598-8501
Practice Address - Fax:936-598-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081705801Medicaid
410031769OtherRAILROAD MEDICARE
410031769OtherRAILROAD MEDICARE
TX87G296-TXMedicare PIN