Individual provider Active NPI

Rebecca Lynn Ponder, O.D.

  • Optometrist
  • Dallas, TX
National Provider Identifier
1578645966
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5807TG Issued in TX
Practice address
3888 Oak Lawn Ave
Suite 123
Dallas, TX 75219-4605
Phone
(214) 528-4050
Fax
(214) 528-8912
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5807TG TX Primary

Addresses

Primary practice location

3888 Oak Lawn Ave
Suite 123
Dallas, TX 75219-4605

Mailing address

3888 Oak Lawn Ave
Suite 123
Dallas, TX 75219-4605
Phone (214) 528-4050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578645966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3888 OAK LAWN AVE",
            "address_2": "SUITE 123",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194605",
            "telephone_number": "214-528-4050",
            "fax_number": "214-528-8912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3888 OAK LAWN AVE",
            "address_2": "SUITE 123",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752194605",
            "telephone_number": "214-528-4050",
            "fax_number": "214-528-8912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONDER",
        "first_name": "REBECCA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5807TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.