Organization Active NPI

University of Texas Southwestern Medical Center at Dallas

  • Ophthalmology Physician
  • Fort Worth, TX
National Provider Identifier
1225082050
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS
Practice address
600 S Main St
Fort Worth, TX 76104-2410
Phone
(817) 882-2400
NPI assigned
May 19, 2006
Last updated
Oct 16, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLASAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Authorized official

Name
Mark Meyer, M.D.
Title
Executive Vice President
Phone
(214) 648-0309

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

600 S Main St
Fort Worth, TX 76104-2410

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 645-0624

Other practice location 1

1575 S Main St
Fort Worth, TX 76104-4901
Phone (817) 702-1215

Other identifiers 1

IdentifierTypeStateIssuer
086893704MedicaidTX

Other names 1

  • UTSW Ophthalmology Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031106000792 TX Part B Supplier - Clinic/Group Practice 0648188250 Receives reassigned benefits from 5,689 practitioners
46 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 43

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 43

National Provider Directory

National Provider Directory
Tax ID family
University of Texas Southwestern Medical Center79 organizations share this tax ID, including this one
Part of
University of Texas Southwestern Medical Center

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760572800000",
    "number": "1225082050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-645-0624",
            "fax_number": "214-645-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042410",
            "telephone_number": "817-882-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1575 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044901",
            "country_code": "US",
            "telephone_number": "817-702-1215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS",
        "enumeration_date": "2006-05-19",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "214-648-0309",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "086893704",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UTSW Ophthalmology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.