Individual provider Active NPI

David Richard Stager Jr., M.D.

  • Ophthalmology Physician
  • Plano, TX
National Provider Identifier
1982654216
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
J1572 Issued in TX
Practice address
3801 W 15TH St
A110
Plano, TX 75075-4737
Phone
(972) 758-0625
Fax
(972) 964-5725
NPI assigned
May 10, 2006
Last updated
Jul 30, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X J1572 TX Primary

Addresses

Primary practice location

3801 W 15TH St
A110
Plano, TX 75075-4737

Mailing address

3801 W 15TH St
A110
Plano, TX 75075-4737
Phone (972) 758-0625

Other identifiers 2

IdentifierTypeStateIssuer
129544605MedicaidTX
129544606MedicaidTX

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100604000458 TX Practitioner - Ophthalmology 8123158920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J1572TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Luu Little Eyes, PLLC CurrentSince Oct 22, 2023 Accepting new patients
Pediatric Ophthalmology PA Ophthalmology Past Accepting new patients

Locations

3801 W 15th St
#A110
Plano, TX 75075
Phone (972) 758-0625

3801 W 15th St
Ste A110
Plano, TX 75075
Phone (972) 758-0625

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1982654216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 W 15TH ST",
            "address_2": "A110",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750754737",
            "telephone_number": "972-758-0625",
            "fax_number": "972-964-5725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 W 15TH ST",
            "address_2": "A110",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750754737",
            "telephone_number": "972-758-0625",
            "fax_number": "972-964-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAGER",
        "first_name": "DAVID",
        "middle_name": "RICHARD",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "J1572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129544605",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129544606",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.