Glenn G Deshaw OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

GLENN G DESHAW OD PA

Practice address

2636 W Walnut St
Ste. 200
Garland, TX 75042-6441

Phone

(972) 485-0700

Fax

(972) 485-0702

NPI assigned

Jan 12, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jonathan Deshaw, ODNPI 1407160815

Title

Owner

Phone

(972) 485-0700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Jonathan Glenn Deshaw, O.D.

  • Optometrist
  • Garland, TX
  • NPI 1407160815
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559606400000",
    "number": "1265762363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2636 W WALNUT ST",
            "address_2": "STE. 200",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750426441",
            "telephone_number": "972-485-0700",
            "fax_number": "972-485-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2636 W WALNUT ST",
            "address_2": "STE. 200",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750426441",
            "telephone_number": "972-485-0700",
            "fax_number": "972-485-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN G DESHAW OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-12",
        "last_updated": "2019-06-04",
        "status": "A",
        "authorized_official_last_name": "DESHAW",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-485-0700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gils Home Health Care Services Inc
• Gina Holmes Nutrition LLC
• Erica Caryn Givens, RD
• Toby J Glaser Glaser, DDS
• Joanna N. Glaze, WHCNP
• Global Extended Care Homehealth LLC
• Global NP Healthcare PLLC
• Glorious Home Health Care Inc.
• Gmac Pathway Inc
• Golden Clinic Services LLC

• Optometrist in Garland, TX
• Providers in Garland, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.