Individual provider · NPI-1

Dr. Carl W Childress, O.D.

Optometrist, Sports Vision · Longview, TX

NPI number1801902606
StatusActive
Last updated in NPPESSep 11, 2025

Details

NPI
1801902606
Entity type
Individual (NPI-1)
Name
Dr. Carl W Childress
Credential
O.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 22, 2006
Last updated
Sep 11, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152WS0006X Optometrist, Sports Vision1892TXYes
152WC0802X Optometrist, Corneal and Contact Management1892TX
152WL0500X Optometrist, Low Vision Rehabilitation1892TX
152WP0200X Optometrist, Pediatrics1892TX
152WV0400X Optometrist, Vision Therapy1892TX

Practice location

408 E Magrill St
Longview, TX 75601-6444

Phone 903-753-4436 · Fax 903-757-4400

Mailing address

408 Magrill Street
Longview, TX 75601-6444

Phone 903-753-4436 · Fax 903-757-4400

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Optometrist, Sports Vision providers in Longview, TX