Organization Active NPI

David W Tybor OD PC

  • Optometrist
  • Austin, TX
National Provider Identifier
1255303442
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3233TG Issued in TX
Legal business name
DAVID W TYBOR OD PC
Doing business as
Oak Hill Eye Care
Practice address
6000 W William Cannon Dr
BLDG a Ste 100
Austin, TX 78749-1975
Phone
(512) 288-0444
Fax
(512) 288-1009
NPI assigned
Feb 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2012

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

Authorized official

Name
Miss Tamara R Harper
Title
Office Assistant
Phone
(512) 288-0444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3233TG TX Primary

Addresses

Primary practice location

6000 W William Cannon Dr
BLDG a Ste 100
Austin, TX 78749-1975

Mailing address

6000 W WM Cannon
BLDG a Ste 100
Austin, TX 78749
Phone (512) 288-0444

Other identifiers 2

IdentifierTypeStateIssuer
00E28COtherTXBLUE CROSS BLUE SHIELD
1123507MedicaidTX

Other names 1

  • Oak Hill Eye Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051111000200 TX Part B Supplier - Clinic/Group Practice 1355369034 Receives reassigned benefits from 4 practitioners
Practice locations: Austin, TX

National Provider Directory

National Provider Directory

Locations

6000 W William Cannon Dr
Ste A100
Austin, TX 78749
Phone (512) 288-0444

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1255303442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 W WM CANNON",
            "address_2": "BLDG A STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78749",
            "telephone_number": "512-288-0444",
            "fax_number": "512-288-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 W WILLIAM CANNON DR",
            "address_2": "BLDG A STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491975",
            "telephone_number": "512-288-0444",
            "fax_number": "512-288-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID W TYBOR OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2012-05-09",
        "status": "A",
        "authorized_official_last_name": "HARPER",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE ASSISTANT",
        "authorized_official_telephone_number": "512-288-0444",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3233TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00E28C",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1123507",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Hill Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; 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.