NPIMap

Organization Active NPI

Donald E Rexroad OD PC

  • Optometrist
  • Brenham, TX
National Provider Identifier
1184947400
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2133T Issued in TX
Legal business name
DONALD E REXROAD OD PC
Practice address
2648 Highway 36 S
Brenham, TX 77833-9600
Phone
(979) 836-1077
Fax
(979) 830-1573
NPI assigned
Mar 2, 2010
Last updated
Mar 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

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

Authorized official

Name
Dr. Donald Rexroad, OD PCNPI 1134133036
Title
Optometrist
Phone
(979) 836-1077

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2133T TX Primary

Addresses

Primary practice location

2648 Highway 36 S
Brenham, TX 77833-9600

Mailing address

2648 Highway 36 S
Brenham, TX 77833-9600
Phone (979) 836-1077

Other identifiers 2

IdentifierTypeStateIssuer
121655801MedicaidTX
00E84BOtherTXMEDICARE ID-TYPE UNSPECIFIED

National Provider Directory

National Provider Directory

Locations

2648 Highway 36 S
Brenham, TX 77833
Phone (979) 836-1077

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267488000000",
    "number": "1184947400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2648 HIGHWAY 36 S",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778339600",
            "telephone_number": "979-836-1077",
            "fax_number": "979-830-1573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2648 HIGHWAY 36 S",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778339600",
            "telephone_number": "979-836-1077",
            "fax_number": "979-830-1573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD E REXROAD OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-02",
        "last_updated": "2010-03-02",
        "status": "A",
        "authorized_official_last_name": "REXROAD",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "979-836-1077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD PC"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2133T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121655801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "00E84B",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.