Provider Demographics
NPI:1699739797
Name:METCALF, PRISCILLA J (MD)
Entity type:Individual
Prefix:DR
First Name:PRISCILLA
Middle Name:J
Last Name:METCALF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:10119 US HIGHWAY 59 SOUTH
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WHARTON
Mailing Address - State:TX
Mailing Address - Zip Code:77488-9719
Mailing Address - Country:US
Mailing Address - Phone:979-533-7337
Mailing Address - Fax:979-488-2918
Practice Address - Street 1:10119 US HIGHWAY 59 SOUTH
Practice Address - Street 2:SUITE 4
Practice Address - City:WHARTON
Practice Address - State:TX
Practice Address - Zip Code:77488-9719
Practice Address - Country:US
Practice Address - Phone:979-533-7337
Practice Address - Fax:979-488-2918
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG2783207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP01948495OtherRAILROAD MEDICARE PTAN
TX119164508Medicaid
TX8HB479OtherBCBS
TX8DE539OtherBC/BS #
TXP01090510OtherRAILROAD MEDICARE PTAN
TXMDG2783TXOtherWORKERS COMPENSATION
TX119164505Medicaid
TX887905Medicare ID - Type Unspecified
TX887905OtherBC/BS TX#
TXMDG2783TXOtherWORKERS COMPENSATION