NPIMap

Organization Active NPI

Paul C. Tisdal, O.D., P.C.

Doing business as Weatherford Eyecare Center

  • Optometrist
  • Weatherford, OK
National Provider Identifier
1427260256
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1016 Issued in OK
Legal business name
PAUL C. TISDAL, O.D., P.C.
Doing business as
Weatherford Eyecare Center
Practice address
1545 N. Washington Ave
Weatherford, OK 73096
Phone
(158) 072-2819
Fax
(158) 077-2280
NPI assigned
May 4, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Paul Carroll Tisdal, O.D.NPI 1760430938
Title
President
Phone
(580) 772-2819

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1016 OK Primary

Addresses

Primary practice location

1545 N. Washington Ave
Weatherford, OK 73096

Mailing address

P.O. Box 308
Weatherford, OK 73096
Phone (580) 772-2819

Other identifiers 1

IdentifierTypeStateIssuer
1760430938OtherOKNPI TYPE 1

Other names 1

  • Weatherford Eyecare Center Doing business as

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: jsmart@weatherfordeyecare.eyefinity-direct.com
  • Direct secure messaging: pctisdal2@weatherfordeyecare.eyefinity-direct.com

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427260256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 308",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "73096",
            "telephone_number": "580-772-2819",
            "fax_number": "580-772-2805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 N. WASHINGTON AVE",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "73096",
            "telephone_number": "158-072-2819",
            "fax_number": "158-077-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL C. TISDAL, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TISDAL",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "CARROLL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "580-772-2819",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OK",
            "license": "1016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 1",
            "identifier": "1760430938",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weatherford Eyecare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Weatherford, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.