Individual provider Active NPI

Carroll David Dick, O.D.

  • Optometrist
  • Gainesville, TX
National Provider Identifier
1003898321
Registry record updated Oct 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
06706TG Issued in TX
Practice address
818 W Hwy 82
Gainesville, TX 76240
Phone
(940) 665-9111
Fax
(940) 665-9111
NPI assigned
Nov 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 06706TG TX Primary

Addresses

Primary practice location

818 W Hwy 82
Gainesville, TX 76240

Mailing address

818 W Hwy 82
Gainesville, TX 76240
Phone (940) 665-9111

Other identifiers 1

IdentifierTypeStateIssuer
214483401MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6706TXMDBehavioral Analyst
06706TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Optometric Center of Dr. D. Gary Thomas and Associates Optometrist PastSince Jan 10, 2003 Accepting new patients
Texoma Retina Center PA PastSince May 3, 2010 Accepting new patients
Eye Surgeons Associates PC Optometrist Past Accepting new patients
Eye Doctors Optometrist PastSince Apr 1, 2013 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288310400000",
    "number": "1003898321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 W HWY 82",
            "city": "GAINESVILLE",
            "state": "TX",
            "postal_code": "76240",
            "telephone_number": "940-665-9111",
            "fax_number": "940-665-2508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 W HWY 82",
            "city": "GAINESVILLE",
            "state": "TX",
            "postal_code": "76240",
            "telephone_number": "940-665-9111",
            "fax_number": "940-665-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICK",
        "first_name": "CARROLL",
        "middle_name": "DAVID",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2010-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "06706TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214483401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.