Individual provider Active NPI

Timothy Edward Bowers, O.D.

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1801847116
Registry record updated Nov 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6276TG Issued in TX
Practice address
4919 S Hulen St
Fort Worth, TX 76132-1407
Phone
(817) 370-2100
NPI assigned
May 12, 2006
Last updated
Nov 4, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6276TG TX Primary
Corneal and Contact Management Optometrist 152WC0802X 6276TG TX
Vision Therapy Optometrist 152WV0400X 6276TG TX

Addresses

Primary practice location

4919 S Hulen St
Fort Worth, TX 76132-1407

Mailing address

4919 S Hulen St
Fort Worth, TX 76132-1407
Phone (817) 370-2100

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
I20050406000377 TX Practitioner - Optometry 2365499985 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Granbury Eye Care PCGroup PAC ID 5092809350, 2 clinicians

Practice addresses (Care Compare)

1101 Waters Edge Dr
Granbury, TX 76048-1474
Phone (817) 579-7933

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6276TGTXMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Granbury Eye Care PC Optometrist CurrentSince Jul 5, 2015 Accepting new patients
Vision Expo Group PLLC Optometrist CurrentSince Jan 14, 2014 Accepting new patients
Dann Martin O.D.,P.a. Optometrist CurrentSince Feb 8, 2005 Accepting new patients
Advanced Visioncare of Mansfield PA Optometrist Past Accepting new patients
Advanced Visioncare of Fort Worth PA Optometrist Past Accepting new patients

Locations

4605 S Cooper St
Arlington, TX 76017
Phone (817) 557-9595

5520 S Cooper St
Ste 110
Arlington, TX 76017
Phone (817) 467-2020

1101 Waters Edge Dr
Ste 104
Granbury, TX 76048
Phone (817) 579-7933

Organizations & group practices 5

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": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288828800000",
    "number": "1801847116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4919 S HULEN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761321407",
            "telephone_number": "817-370-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4919 S HULEN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761321407",
            "telephone_number": "817-370-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERS",
        "first_name": "TIMOTHY",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2010-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6276TG",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "6276TG",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "TX",
            "license": "6276TG",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.