Active NPI
Randy Anthony Wiebelhaus, O.D.
- Optometrist
- Denton, TX
National Provider Identifier
1801022504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4002T
- Practice address
- 2430 S I-35 E # South
Suite 156
Denton, TX 76205-4986 - Phone
- (940) 484-8857
- Fax
- (940) 387-1998
- NPI assigned
- Jun 9, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4002T | TX | Primary |
Addresses
Primary practice location
2430 S I-35 E # South
Suite 156
Denton, TX 76205-4986
Mailing address
1309 Lynhurst LN
Denton, TX 76205-8079
Phone (940) 484-8857
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4002T | TX | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244505600000",
"number": "1801022504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1309 LYNHURST LN",
"city": "DENTON",
"state": "TX",
"postal_code": "762058079",
"telephone_number": "940-484-8857",
"fax_number": "940-387-1998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2430 S I-35 E # SOUTH",
"address_2": "SUITE 156",
"city": "DENTON",
"state": "TX",
"postal_code": "762054986",
"telephone_number": "940-484-8857",
"fax_number": "940-387-1998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIEBELHAUS",
"first_name": "RANDY",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-09",
"last_updated": "2009-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "4002T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.