NPIMap

Organization Active NPI

Steven W. Coburn, O.D., P.a.

  • Optometrist
  • Denton, TX
National Provider Identifier
1457403552
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2596TG Issued in TX
Legal business name
STEVEN W. COBURN, O.D., P.A.
Practice address
3327 Colorado Blvd
Suite 300
Denton, TX 76210-6865
Phone
(940) 566-3413
Fax
(940) 381-1828
NPI assigned
Jan 17, 2007
Last updated
Feb 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Authorized official

Name
Dr. Steven W. Coburn, O.D.NPI 1780736876
Title
President
Phone
(940) 566-3413

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 2596TG TX Primary

Addresses

Primary practice location

3327 Colorado Blvd
Suite 300
Denton, TX 76210-6865

Mailing address

3327 Colorado Blvd
Suite 300
Denton, TX 76210
Phone (940) 566-3413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050810001177 TX Part B Supplier - Clinic/Group Practice 9133158009 Receives reassigned benefits from 2 practitioners
Practice locations: Denton, TX
O20100930005953 TX DME Supplier - Physician - OptometristDME Supplier - Optician 9133158009 Practice locations: Denton, TX

National Provider Directory

National Provider Directory

Locations

3327 Colorado Blvd
Ste 300
Denton, TX 76210
Phone (940) 566-3413

Practitioners & affiliated clinicians

Practitioners 4

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": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1457403552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3327 COLORADO BLVD",
            "address_2": "SUITE 300",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "76210",
            "telephone_number": "940-566-3413",
            "fax_number": "940-381-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3327 COLORADO BLVD",
            "address_2": "SUITE 300",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762106865",
            "telephone_number": "940-566-3413",
            "fax_number": "940-381-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN W. COBURN, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "COBURN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "940-566-3413",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2596TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.