Active NPI
Brenda K Byrd, O.D.
- Optometrist
- Fort Worth, TX
National Provider Identifier
1376549600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 04954TG
- Practice address
- 1201 Summit Ave
Fort Worth, TX 76102-4427 - Phone
- (817) 332-2020
- Fax
- (817) 332-4797
- NPI assigned
- Jun 22, 2005
- Sex
- Female
- 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 | 04954TG | TX | Primary |
Addresses
Primary practice location
1201 Summit Ave
Fort Worth, TX 76102-4427
Mailing address
1201 Summit Ave
Fort Worth, TX 76102-4427
Phone (817) 332-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 82010E | Other | TX | BCBS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04954TG | TX | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196640000000",
"number": "1376549600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 SUMMIT AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761024427",
"telephone_number": "817-332-2020",
"fax_number": "817-332-4797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 SUMMIT AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761024427",
"telephone_number": "817-332-2020",
"fax_number": "817-332-4797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BYRD",
"first_name": "BRENDA",
"middle_name": "K",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-22",
"last_updated": "2007-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "04954TG",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "82010E",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.