Active NPI
Gayle Daniels, OD
- Optometrist
- Fort Worth, TX
National Provider Identifier
1447252374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5343T
- Practice address
- 2440 Jacksboro Hwy
Fort Worth, TX 76114-2201 - Phone
- (817) 626-3721
- Fax
- (817) 626-2006
- NPI assigned
- Aug 11, 2005
- Last updated
- Aug 9, 2016
- 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 | 5343T | TX | Primary |
Addresses
Primary practice location
2440 Jacksboro Hwy
Fort Worth, TX 76114-2201
Mailing address
2440 Jacksboro Hwy
Fort Worth, TX 76114-2201
Phone (817) 626-3721
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019440901 | Medicaid | TX |
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 |
|---|---|---|---|
| 5343T | TX | MD | Optometrist |
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, 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": "1123718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470700800000",
"number": "1447252374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2440 JACKSBORO HWY",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761142201",
"telephone_number": "817-626-3721",
"fax_number": "817-626-2006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2440 JACKSBORO HWY",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761142201",
"telephone_number": "817-626-3721",
"fax_number": "817-626-2006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELS",
"first_name": "GAYLE",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-11",
"last_updated": "2016-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "5343T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "019440901",
"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 Aug 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.