O Keith Dishman, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

TX1940TG Issued in TX

Practice address

4311 Oak Lawn Ave
Ste.# C125
Dallas, TX 75219-2315

Phone

(214) 521-0929

Fax

(214) 521-2502

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1497835490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 OAK LAWN AVE",
            "address_2": "STE.# C125",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192315",
            "telephone_number": "214-521-0929",
            "fax_number": "214-521-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 OAK LAWN AVE",
            "address_2": "STE.# C125",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192315",
            "telephone_number": "214-521-0929",
            "fax_number": "214-521-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISHMAN",
        "first_name": "O",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "TX1940TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093189102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Discovering Hope
• Discovering Hope
• Discovery Laboratory LLC
• Discovery Texas Interventional Psychiatry PLLC
• Jesse Dishaw
• Emma Lucille Dishner, MPH
• Leigh Alice Dismukes, OTR
• Laine M Distefano, MS, LMFT
• Distinctive Diagnostics, PLLC
• Nancy L. Ditman, CNM

• Corneal and Contact Management Optometrist in Dallas, TX
• Providers in Dallas, TX by specialty
• Corneal and Contact Management Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.