Gary G Deckelboim, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

J0940 Issued in TX

Practice address

8210 Walnut Hill LN
Suite 100 LB-5
Dallas, TX 75231-4405

Phone

(214) 369-8478

Fax

(214) 696-1594

NPI assigned

Feb 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bert C. Bryan M.D. P.a.

  • Ophthalmology Physician
  • Dallas, TX
  • NPI 1184952624
  NPD (past)

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1912979790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8210 WALNUT HILL LN",
            "address_2": "SUITE 100 LB-5",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314405",
            "telephone_number": "214-369-8478",
            "fax_number": "214-696-1594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8210 WALNUT HILL LN",
            "address_2": "SUITE 100 LB-5",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752314405",
            "telephone_number": "214-369-8478",
            "fax_number": "214-696-1594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKELBOIM",
        "first_name": "GARY",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "J0940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marsha Morrell Decay, CRNA
• Shagayla L. Decena, LPC
• Kaitlyn Marie Dechant, PSYD
• Jennifer Pitz Deck, DDS
• Danny Trew Deckard, PA
• Jacqueline S Decker, PA-C
• M'Kinna Decker
• Marshal Neil Decker, ATP, RRTS
• Meredith Decoy
• Dede Cares

• Ophthalmology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.