Individual provider Active NPI

Ninh Manh Dam, O.D.

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1396806576
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4792T Issued in TX
Practice address
8923 W Military Dr
Suite 109
San Antonio, TX 78245-2102
Phone
(210) 767-1717
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4792T TX Primary

Addresses

Primary practice location

8923 W Military Dr
Suite 109
San Antonio, TX 78245-2102

Mailing address

7722 Alverstone Way
San Antonio, TX 78250-2987
Phone (210) 684-2011

Other names 1

  • Dr. David Manh Dam Other name

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
I20110721000270 TX Practitioner - Optometry 4981872736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8923 W Military Dr
Suite 109
San Antonio, TX 78245-2102
Phone (210) 767-1717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4792TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
DK Eyecare, P.C. Optometrist CurrentSince Jun 28, 2011 Accepting new patients

Locations

8923 W Military Dr
Ste 109
San Antonio, TX 78245
Phone (210) 767-1717

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396806576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7722 ALVERSTONE WAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782502987",
            "telephone_number": "210-684-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8923 W MILITARY DR",
            "address_2": "SUITE 109",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782452102",
            "telephone_number": "210-767-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAM",
        "first_name": "NINH",
        "middle_name": "MANH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4792T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "DAM",
            "middle_name": "MANH",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.