Diane Serex-Dougan, O.D.

Primary specialty

Pediatric OptometristTaxonomy code 152WP0200X

License

TAO849 Issued in MD

Legal business name

DIANE SEREX-DOUGAN, O.D.

Practice address

7954 Harford Rd
Baltimore, MD 21234-5838

Phone

(443) 629-5459

NPI assigned

Jun 6, 2018

Last updated

Jun 6, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Diane R Serex-Dougan, O.D.NPI 1154300309

Title

Optometrist

Phone

(443) 629-5459

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Diane Serex-Dougan, O.D.

  • Pediatric Optometrist
  • Baltimore, MD
  • NPI 1154300309

  Pediatrics

  NPD Authorized official

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528243200000",
    "number": "1285126011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7954 HARFORD RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212345838",
            "telephone_number": "443-629-5459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7954 HARFORD RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212345838",
            "telephone_number": "443-629-5459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANE SEREX-DOUGAN, O.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-06",
        "last_updated": "2018-06-06",
        "status": "A",
        "authorized_official_last_name": "SEREX-DOUGAN",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "443-629-5459",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "MD",
            "license": "TAO849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1154300309",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Optometrist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Pediatric Optometrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.