Individual provider Active NPI

Steven David Bresnahan, O.D.

  • Pediatric Optometrist
  • Burleson, TX
National Provider Identifier
1104843168
Registry record updated Oct 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric OptometristTaxonomy code 152WP0200X
License
5612T Issued in TX
Practice address
201 NW Renfro St
Burleson, TX 76028-4113
Phone
(817) 295-5601
Fax
(817) 295-1884
NPI assigned
Jul 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Optometrist 152WP0200X 5612T TX Primary

Addresses

Primary practice location

201 NW Renfro St
Burleson, TX 76028-4113

Mailing address

201 NW Renfro St
Burleson, TX 76028-4113
Phone (817) 295-5601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140515000506 TX Practitioner - Optometry 5395968580 Practice locations: Burleson, TX

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

201 NW Renfro St
Burleson, TX 76028-4113
Phone (817) 295-5601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5612TXMDChiropractor
5612TTXMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven D Bresnahan PastSince Feb 2, 2014 Accepting new patients

Organizations & group practices 1

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412812800000",
    "number": "1104843168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 NW RENFRO ST",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760284113",
            "telephone_number": "817-295-5601",
            "fax_number": "817-295-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 NW RENFRO ST",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760284113",
            "telephone_number": "817-295-5601",
            "fax_number": "817-295-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRESNAHAN",
        "first_name": "STEVEN",
        "middle_name": "DAVID",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2014-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "TX",
            "license": "5612T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

Verify at the official NPI Registry.