Individual provider Active NPI

Deborah Zanella, O.D.

  • Optometrist
  • Southlake, TX
National Provider Identifier
1497813646
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6867T Issued in TX
Practice address
1251 East Southlake Boulevard
Suite 331
Southlake, TX 76092
Phone
(817) 310-0289
Fax
(817) 310-0684
NPI assigned
Dec 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6867T TX Primary

Addresses

Primary practice location

1251 East Southlake Boulevard
Suite 331
Southlake, TX 76092

Mailing address

2111 Kirkwood Blvd Ste 100
Southlake, TX 76092-1461
Phone (817) 416-2010

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
I20070222000076 TX Practitioner - Optometry 6608978606 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Eye and Laser Center, P.a.Group PAC ID 7315843257, 9 clinicians

Practice addresses (Care Compare)

1872 Norwood Dr
Suite 200
Hurst, TX 76054-7018
Phone (817) 540-6060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6867TXMDChiropractor
6867TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Texas Professional PLLC Optometrist CurrentSince Jan 2, 2021 Accepting new patients
Texas Eye and Laser Center, PA CurrentSince Jan 16, 2025 Accepting new patients
Texas Eye Surgery Center, LLC Past Accepting new patients

Locations

5330 E Mockingbird Ln
Ste 130
Dallas, TX 75206
Phone (214) 341-9955

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

1872 Norwood Dr
Ste 200
Hurst, TX 76054
Phone (817) 540-6060

2111 Kirkwood Blvd
Ste 100
Southlake, TX 76092
Phone (817) 416-2010

670 E Southlake Blvd
Southlake, TX 76092
Phone (817) 329-6466

Organizations & group practices 3

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": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1497813646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 KIRKWOOD BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921461",
            "telephone_number": "817-416-2010",
            "fax_number": "817-416-2013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 EAST SOUTHLAKE BOULEVARD",
            "address_2": "SUITE 331",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "76092",
            "telephone_number": "817-310-0289",
            "fax_number": "817-310-0684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZANELLA",
        "first_name": "DEBORAH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6867T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.