Organization Active NPI

W. Ryan Butler OD PLLC

  • Optometrist
  • Round Rock, TX
National Provider Identifier
1912218082
Registry record updated Nov 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5811TG Issued in TX
Legal business name
W. RYAN BUTLER OD PLLC
Practice address
1150 Ih35 North Suite 500
Round Rock, TX 78681-4221
Phone
(512) 828-5500
Fax
(512) 828-5501
NPI assigned
Jun 23, 2010
Last updated
Nov 10, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2016

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

Authorized official

Name
Dr. W Ryan Butler, O.D.
Title
Managing Member
Phone
(512) 828-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5811TG TX Primary

Addresses

Primary practice location

1150 Ih35 North Suite 500
Round Rock, TX 78681-4221

Mailing address

1150 Ih35 North Suite 500
Round Rock, TX 78681-4221
Phone (512) 828-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110614000073 TX Part B Supplier - Clinic/Group Practice 2062699390 Receives reassigned benefits from 1 practitioner
Practice locations: Round Rock, TX

National Provider Directory

National Provider Directory

Locations

1150 Ih 35 N
Ste 500
Round Rock, TX 78681
Phone (512) 828-5500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478736000000",
    "number": "1912218082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 IH35 NORTH SUITE 500",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814221",
            "telephone_number": "512-828-5500",
            "fax_number": "512-828-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 IH35 NORTH SUITE 500",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814221",
            "telephone_number": "512-828-5500",
            "fax_number": "512-828-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W. RYAN BUTLER OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-23",
        "last_updated": "2016-11-10",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "W",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "512-828-5500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5811TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.