Individual provider Active NPI

Zane A Vandiver, O.D.

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1548241847
Registry record updated Aug 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4359TG Issued in TX
Practice address
7201 Boat Club Rd
Fort Worth, TX 76179-4555
Phone
(817) 750-2233
Fax
(817) 750-2266
NPI assigned
Nov 14, 2005
Last updated
Aug 7, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4359TG TX Primary

Addresses

Primary practice location

7201 Boat Club Rd
Fort Worth, TX 76179-4555

Mailing address

7201 Boat Club Rd
Fort Worth, TX 76179-4555
Phone (817) 750-2233

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
I20050216000742 TX Practitioner - Optometry 0840242988 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

7201 Boat Club Rd
Fort Worth, TX 76179-4555
Phone (817) 750-2233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4359TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Texas Professional PLLC Optometrist CurrentSince Jul 14, 2024 Accepting new patients
William L Aston OD and Melissa a Aston OD PC Optometrist CurrentSince Aug 5, 2013 Accepting new patients
Dianne Bui Dao OD PC Optometrist PastSince Apr 24, 2011 Accepting new patients
Pope Enterprises PLLC Optometrist Past Accepting new patients
Dr. de Grasse & Associates, P.a. Optometrist PastSince May 21, 2001 Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients

Locations

3908 Far West Blvd
Austin, TX 78731
Phone (512) 343-0432

12320 Barker Cypress Rd
Ste 400
Cypress, TX 77429
Phone (281) 373-1020

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

7201 Boat Club Rd
Fort Worth, TX 76179
Phone (817) 750-2233

7201 Boat Club Rd
Ste 101
Fort Worth, TX 76179
Phone (817) 750-2233

1102 S Friendswood Dr
Ste A
Friendswood, TX 77546
Phone (281) 482-0066

6850 N Shiloh Rd
Ste T
Garland, TX 75044
Phone (972) 414-0444

2705 Broadway St
Ste 115
Pearland, TX 77581
Phone (281) 485-2020

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

Organizations & group practices 6

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": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375833600000",
    "number": "1548241847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 BOAT CLUB RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761794555",
            "telephone_number": "817-750-2233",
            "fax_number": "817-750-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 BOAT CLUB RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761794555",
            "telephone_number": "817-750-2233",
            "fax_number": "817-750-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDIVER",
        "first_name": "ZANE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2013-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4359TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.