Active NPI
Paul William Wuthrich, MD
- Ophthalmology Physician
- Bryan, TX
National Provider Identifier
1164534178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- H8528
- Practice address
- 3811 Sagebriar Dr
Bryan, TX 77802-6107 - Phone
- (979) 774-0498
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | H8528 | TX | Primary |
Addresses
Primary practice location
3811 Sagebriar Dr
Bryan, TX 77802-6107
Mailing address
20850 FM 159 Rd
Navasota, TX 77868-7014
Phone (936) 825-7535
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8R9482 | Other | TX | BCBS ID # |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| H8528 | TX | MD | Ophthalmology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164534178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20850 FM 159 RD",
"city": "NAVASOTA",
"state": "TX",
"postal_code": "778687014",
"telephone_number": "936-825-7535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3811 SAGEBRIAR DR",
"city": "BRYAN",
"state": "TX",
"postal_code": "778026107",
"telephone_number": "979-774-0498"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WUTHRICH",
"first_name": "PAUL",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "TX",
"license": "H8528",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS ID #",
"identifier": "8R9482",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bryan, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.