Gary L Womack, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

E9467 Issued in TX

Practice address

1327 Troup Hwy
Tyler, TX 75701

Phone

(903) 606-4733

NPI assigned

Jul 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Collom & Carney Clinic Association

  • Cardiovascular Disease Physician
  • Texarkana, TX
  • NPI 1013252279
  NPD
• Collom & Carney Clinic Association

  • Clinical Medical Laboratory
  • Texarkana, TX
  • NPI 1164405296
  NPD
• Collom & Carney Clinic Association

  • Pain Medicine (Anesthesiology) Physician
  • Texarkana, TX
  • NPI 1962829747
  NPD

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1225038565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846098",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752846098",
            "telephone_number": "903-324-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 TROUP HWY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-606-4733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5402 Summerhill Rd",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "TX",
            "postal_code": "755034607",
            "country_code": "US",
            "telephone_number": "903-614-3937",
            "fax_number": "903-614-3525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOMACK",
        "first_name": "GARY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "E9467",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "AR",
            "license": "N5777",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135498709",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123703001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135498706",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "820733",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8LE706",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hailegiorgis A Woldegiorgis, MD
• Dejene Woldemariam, PHARMD
• Angela Wolf
• Scott William Wolf, MD
• Ashley Danelle Womack, ATC, LAT
• Noah Womack, CPO
• Womens Environment
• Womens Total Care of East Texas
• Drew C Woock, OT
• Amber Dionne Wood, AGACNP-C

• Ophthalmology Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; 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.