Granbury Eye Care PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

5503TG Issued in TX

Legal business name

GRANBURY EYE CARE PC

Practice address

1101 Waters Edge Dr
Ste 104
Granbury, TX 76048-1474

Phone

(817) 579-7933

NPI assigned

Sep 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bruce B Wadley, O.D.NPI 1184613739

Title

Owner/President

Phone

(817) 579-7933

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bruce B Wadley, OD

  • Optometrist
  • Granbury, TX
  • NPI 1184613739
  Medicare reassignment Care Compare group NPD Authorized official
• Timothy Edward Bowers, O.D.

  • Optometrist
  • Fort Worth, TX
  • NPI 1801847116
  Medicare reassignment Care Compare group NPD
• Justin Molder

  • Optometrist
  • Midlothian, TX
  • NPI 1568394732
  NPD (past)
• Cindy Marie Zimmerman, O.D.

  • Optometrist
  • Fort Worth, TX
  • NPI 1093963043
  NPD (past)

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267228800000",
    "number": "1700071883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 WATERS EDGE DR",
            "address_2": "STE 104",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481474",
            "telephone_number": "817-579-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 WATERS EDGE DR",
            "address_2": "STE 104",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481474",
            "telephone_number": "817-579-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANBURY EYE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2010-02-27",
        "status": "A",
        "authorized_official_last_name": "WADLEY",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "817-579-7933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5503TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ginger Suzanne Goodchild, D.O.
• Laura Nicole Graham, LPC
• Granbury 2300 Opco LLC
• Granbury Chiropractic Wellness Center
• Granbury Executive Transport, LLC
• Granbury Family Med Clinic
• Granbury Hood County Emergency
• Granbury Hospital Corporation
• Granbury Hospital Corporation
• Granbury II Enterprises, LLC

• Optometrist in Granbury, TX
• Providers in Granbury, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.