Individual provider Active NPI

Warren David Awalt, OD

  • Optometrist
  • Conroe, TX
National Provider Identifier
1578535746
Registry record updated Jan 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4217T Issued in TX
Practice address
1422 B Loop 336 W
Conroe, TX 77304
Phone
(936) 539-2020
Fax
(936) 756-7916
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4217T TX Primary

Addresses

Primary practice location

1422 B Loop 336 W
Conroe, TX 77304

Mailing address

1422 B Loop 336 W
Conroe, TX 77304
Phone (936) 539-2020

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
I20040422000506 TX Practitioner - Optometry 0840283487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1990
Medicare assignment
May accept Medicare assignment
Group practices
Conroe Vision Associates PAGroup PAC ID 0648550988, 4 clinicians

Practice addresses (Care Compare)

1422 N Loop 336
Suite B
Conroe, TX 77304-3540
Phone (936) 539-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4217TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Conroe Vision Associates PA Optometrist CurrentSince Jan 31, 2017 Accepting new patients

Locations

1422 N Loop 336 W
Ste B
Conroe, TX 77304
Phone (936) 539-2020

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199750400000",
    "number": "1578535746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 B LOOP 336 W",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "77304",
            "telephone_number": "936-539-2020",
            "fax_number": "936-756-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 B LOOP 336 W",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "77304",
            "telephone_number": "936-539-2020",
            "fax_number": "936-756-7916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWALT",
        "first_name": "WARREN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2008-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4217T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.