Individual provider Active NPI

Laura Elizabeth Wiese, O.D.

  • Optometrist
  • Garland, TX
National Provider Identifier
1780806141
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5470TG Issued in TX
Practice address
1138 Belt Line Rd Ste 230
Garland, TX 75040-1994
Phone
(972) 495-3997
Fax
(972) 414-0912
NPI assigned
May 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 5470TG TX Primary

Addresses

Primary practice location

1138 Belt Line Rd Ste 230
Garland, TX 75040-1994

Mailing address

3104 Cross Bend Rd
Plano, TX 75023-5603
Phone (972) 596-3429

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
I20151006001704 TX Practitioner - Optometry 4082922331 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holly Fisher Britt, O.D., P.C.Group PAC ID 0345542031, 5 clinicians

Practice addresses (Care Compare)

810 Rockwall Pkwy
Suite 2020
Rockwall, TX 75032-6870
Phone (972) 472-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5470TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Holly Fisher Britt, O.D., P.C. Optometrist CurrentSince May 20, 2020 Accepting new patients
Aeg 7 TX Professional, PLLC Optometrist PastSince Feb 11, 2024 Accepting new patients
Aeg Texas Professional PLLC Optometrist PastSince Dec 14, 2020 Accepting new patients

Locations

810 Rockwall Pkwy
#2020
Rockwall, TX 75032
Phone (972) 472-2020

Organizations & group practices 4

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780806141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 CROSS BEND RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750235603",
            "telephone_number": "972-596-3429",
            "fax_number": "972-596-3429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 BELT LINE RD STE 230",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750401994",
            "telephone_number": "972-495-3997",
            "fax_number": "972-414-0912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESE",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5470TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.