Individual provider Active NPI

Garth B Weaver, O.D.

  • Corneal and Contact Management Optometrist
  • Austin, TX
National Provider Identifier
1306880059
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
2900TG Issued in TX
Practice address
3908 Far West Blvd
Austin, TX 78731-2994
Phone
(512) 343-0432
NPI assigned
Jun 15, 2006
Last updated
Sep 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 2900TG TX Primary

Addresses

Primary practice location

3908 Far West Blvd
Austin, TX 78731-2994

Mailing address

2509 Crystal Bend Dr
Pflugerville, TX 78660-8304
Phone (512) 252-8717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090217000136 TX Practitioner - Optometry 1850456302 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2900TGTXMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Texas Professional PLLC CurrentSince Jun 18, 2021 Accepting new patients

Locations

3908 Far West Blvd
Austin, TX 78731
Phone (512) 343-0432

3908 Far West Blvd
Ste B
Austin, TX 78731
Phone (512) 343-0432

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1306880059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 CRYSTAL BEND DR",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786608304",
            "telephone_number": "512-252-8717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3908 FAR WEST BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787312994",
            "telephone_number": "512-343-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "GARTH",
        "middle_name": "B",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "2900TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.