Individual provider Active NPI

David E Weber, OD

  • Optometrist
  • Dallas, TX
National Provider Identifier
1750568192
Registry record updated Apr 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3403T Issued in TX
Practice address
11661 Preston Rd
Ste 145
Dallas, TX 75230-2745
Phone
(214) 368-8825
Fax
(214) 368-8823
NPI assigned
Jan 29, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3403T TX Primary

Addresses

Primary practice location

11661 Preston Rd
Ste 145
Dallas, TX 75230-2745

Mailing address

11661 Preston Rd
Ste 145
Dallas, TX 75230-2745
Phone (214) 368-8825

Other identifiers 1

IdentifierTypeStateIssuer
112388703MedicaidTX

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
I20101206000233 TX Practitioner - Optometry 5092902940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11661 Preston Rd
Suite 145
Dallas, TX 75230-7008
Phone (214) 368-8825

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3403TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
David E Weber OD PC Optometrist CurrentSince Aug 29, 2010 Accepting new patients

Locations

11661 Preston Rd
Ste 145
Dallas, TX 75230
Phone (214) 368-8825

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": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302739200000",
    "number": "1750568192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11661 PRESTON RD",
            "address_2": "STE 145",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302745",
            "telephone_number": "214-368-8825",
            "fax_number": "214-368-8823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11661 PRESTON RD",
            "address_2": "STE 145",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302745",
            "telephone_number": "214-368-8825",
            "fax_number": "214-368-8823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "DAVID",
        "middle_name": "E",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-29",
        "last_updated": "2011-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3403T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112388703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.