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:936-590-2764
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:LOGANSPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71049-0399
Mailing Address - Country:US
Mailing Address - Phone:936-564-2634
Mailing Address - Fax:
Practice Address - Street 1:110 MAIN ST
Practice Address - Street 2:
Practice Address - City:LOGANSPORT
Practice Address - State:LA
Practice Address - Zip Code:71049-2996
Practice Address - Country:US
Practice Address - Phone:936-564-2634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2025-06-25
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