NPIMap

Individual provider Active NPI

Deisy Bautista, O.D

  • Optometrist
  • Rowlett, TX
National Provider Identifier
1821349176
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8076TG Issued in TX
Practice address
3801 Lakeview Pkwy
#400
Rowlett, TX 75088-4079
Phone
(469) 931-0130
Fax
(469) 931-0138
NPI assigned
Sep 26, 2012
Last updated
Mar 16, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8076TG TX Primary

Addresses

Primary practice location

3801 Lakeview Pkwy
#400
Rowlett, TX 75088-4079

Mailing address

3801 Lakeview Pkwy
#400
Rowlett, TX 75088-4079
Phone (469) 931-0130

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

Practice roles

OrganizationSpecialtyStatusNew patients
New Vision Center, PA Optometrist PastSince Apr 2, 2012 Accepting new patients

Organizations & group practices 2

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": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489622400000",
    "number": "1821349176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 LAKEVIEW PKWY",
            "address_2": "#400",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750884079",
            "telephone_number": "469-931-0130",
            "fax_number": "469-931-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 LAKEVIEW PKWY",
            "address_2": "#400",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750884079",
            "telephone_number": "469-931-0130",
            "fax_number": "469-931-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "DEISY",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-26",
        "last_updated": "2017-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8076TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rowlett, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.