Individual provider Active NPI

Amy Elizabeth Davidson, O.D.

  • Optometrist
  • Plano, TX
National Provider Identifier
1164536389
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5234T Issued in TX
Practice address
810 North Central Expressway
Suite 104B Parkway Crossing
Plano, TX 75074-6736
Phone
(972) 423-4435
Fax
(972) 633-0658
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5234T TX Primary

Addresses

Primary practice location

810 North Central Expressway
Suite 104B Parkway Crossing
Plano, TX 75074-6736

Mailing address

14773 Falling Leaf Dr
Frisco, TX 75035-7455
Phone (214) 383-1480

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
I20050629001065 TX Practitioner - Optometry 8820034804 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5234TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Eye and Cataract CurrentSince Mar 1, 2021 Accepting new patients
Bridget a. Shannon, OD,PA Optometrist PastSince Oct 24, 2010 Accepting new patients
Michael J. Niederkorn, O.D., P.a. Optometrist Past Accepting new patients

Locations

101 Ymca Dr
Ste 100
Waxahachie, TX 75165
Phone (469) 505-2020

101 Ymca Dr
Waxahachie, TX 75165
Phone (469) 430-8375

Organizations & group practices 3

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164536389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14773 FALLING LEAF DR",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750357455",
            "telephone_number": "214-383-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 NORTH CENTRAL EXPRESSWAY",
            "address_2": "SUITE 104B PARKWAY CROSSING",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750746736",
            "telephone_number": "972-423-4435",
            "fax_number": "972-633-0658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "AMY",
        "middle_name": "ELIZABETH",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5234T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.