1821481532 NPI number — WEBB OPTOMETRY PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821481532 NPI number — WEBB OPTOMETRY PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEBB OPTOMETRY PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821481532
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 W 7TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLAINVIEW
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79072-6219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-293-1376
Provider Business Mailing Address Fax Number:
806-291-8700

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 W 7TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINVIEW
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79072-6219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-293-1376
Provider Business Practice Location Address Fax Number:
806-291-8700
Provider Enumeration Date:
03/05/2015

Additional Information

Authorized Official

Authorized Official Last Name:
WEBB
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
KENT
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
806-293-1376

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  6267TG , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 6331980001 . This is a "MEDICARE DMERC PTAN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 613994 . This is a "MEDICARE PTAN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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