Active NPI
Robert Joseph Vodvarka, O.D.
- Optometrist
- Dallas, TX
National Provider Identifier
1316922982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2057TG
- Practice address
- 414 Park Forest Ctr
Dallas, TX 75234-8065 - Phone
- (972) 241-8084
- Fax
- (972) 241-8086
- NPI assigned
- Dec 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2057TG | TX | Primary |
Addresses
Primary practice location
414 Park Forest Ctr
Dallas, TX 75234-8065
Mailing address
414 Park Forest Ctr
Dallas, TX 75234-8065
Phone (972) 241-8084
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 410033055 | Other | TX | RAILROAD PROVIDER NUMBER |
| 1669653051 | Other | TX | ORGANIZATION NPI |
| 00386V | Other | TX | MEDICARE GROUP NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297296000000",
"number": "1316922982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 PARK FOREST CTR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752348065",
"telephone_number": "972-241-8084",
"fax_number": "972-241-8086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 PARK FOREST CTR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752348065",
"telephone_number": "972-241-8084",
"fax_number": "972-241-8086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VODVARKA",
"first_name": "ROBERT",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-07",
"last_updated": "2011-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "2057TG",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD PROVIDER NUMBER",
"identifier": "410033055",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ORGANIZATION NPI",
"identifier": "1669653051",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NUMBER",
"identifier": "00386V",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.