Provider Demographics
NPI:1699915579
Name:CHRIS R. RAND O.D.,P.A.
Entity type:Organization
Organization Name:CHRIS R. RAND O.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PA
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:RAND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:254-729-3411
Mailing Address - Street 1:701 MCCLINTIC DR.
Mailing Address - Street 2:
Mailing Address - City:GROESBECK
Mailing Address - State:TX
Mailing Address - Zip Code:76642-2130
Mailing Address - Country:US
Mailing Address - Phone:254-729-3411
Mailing Address - Fax:254-729-3258
Practice Address - Street 1:801 MCCLINTIC DR
Practice Address - Street 2:
Practice Address - City:GROESBECK
Practice Address - State:TX
Practice Address - Zip Code:76642-2130
Practice Address - Country:US
Practice Address - Phone:254-729-3411
Practice Address - Fax:254-729-3258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-04
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6323TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163735701Medicaid
0A4888Medicare PIN
TXU93611Medicare UPIN
TX8A2911Medicare PIN