DR. THEBE BAGWASI (NPI# 1124037320) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124037320 |
| Entity Type | Individual |
| Full Name | DR. THEBE BAGWASI |
| Credential | O.D. |
| Practice Address |
3270 Telegraph Rd Saint Louis MO 63125-5565 |
| Mailing Address |
6 Moray Ct Valley Park MO 63088-1550 |
| Practice Telephone | 3148453164 |
| Mailing Telephone | 3148453164 |
| Mailing Fax Number | 5735170677 |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2007-07-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
2004003244 | MO | Eye and Vision Services Providers |
| Street Address |
3270 TELEGRAPH RD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63125-5565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689691941 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 3270 Telegraph Rd, Saint Louis, MO 63125-5565 | 2006-07-16 |
| 1992305593 | John Marion Love IIi | Pharmacist | 3270 Telegraph Rd, Saint Louis, MO 63125-5565 | 2020-11-01 |
| 1730789652 | Julie Boyer | Pharmacist | 3270 Telegraph Rd, Saint Louis, MO 63125-5565 | 2020-10-29 |
| 1427588185 | Theresa Marie Oliver | Optometrist | 3270 Telegraph Rd, Saint Louis, MO 63125-5565 | 2017-06-15 |
| 1063954246 | Michael David Fitzgerald | Pharmacist | 3270 Telegraph Rd, Saint Louis, MO 63125-5565 | 2016-11-05 |
| 1285183277 | Barbara Bender | Pharmacy Technician | 3270 Telegraph Rd, Saint Louis, MO 63125-5565 | 2016-10-02 |
| 1235567934 | Christopher Bierman | Pharmacist | 3270 Telegraph Rd, Saint Louis, MO 63125-5565 | 2013-10-16 |
| 1437369410 | Bagwasi Od Family Eyecare PC | Optometrist | 3270 Telegraph Rd, Saint Louis, MO 63125-5565 | 2007-05-22 |
| 1750464293 | Wal-mart Stores East, Lp | Technician/Technologist | 3270 Telegraph Rd, Saint Louis, MO 63125-5565 | 2006-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396396990 | Linda Marie Monken | Technician | 3792 Southern Manor, St. Louis, MO 63125 | 2019-09-25 |
| 1194373688 | Angel Angelette Rochelle Ellington | Technician | Va St Louis Spinal Cord Injury Unit, 1 Jefferson Barracks Drive 128/jb, St Louis, MO 63125 | 2019-08-28 |
| 1760940209 | Lea-ed Inc | Community Based Residential Treatment Facility, Mental Illness | 30 Sherman Road, Lemay, MO 63125 | 2019-03-04 |
| 1861957185 | Mary M Ross | Occupational Therapist | Sherbrooke Village, 4005 Ripa Ave, St. Louis, MO 63125 | 2019-02-01 |
| 1013400977 | Anne Henry Francis | Dietitian, Registered | Va St. Louis Health Care System, 1 Jefferson Barracks Drive, St. Louis, MO 63125 | 2018-06-14 |
| 1922458660 | Rebecca Mae Waugh | Skilled Nursing Facility | 1001 Holy Grail Ct, Saint Louis, MO 63125 | 2016-06-14 |
| 1942661814 | Dsk Works LLC | Chiropractor | 3193 Lemay Ferry Rd., Saint Louis, MO 63125 | 2016-03-18 |
| 1467717678 | Despine Louise Coulis | Pediatrics | 7545 S Lindbergh Blvd Ste 220, Saint Louis, MO 63125 | 2012-07-13 |
| 1184914194 | Allison Celeste Cassidy | Pharmacist | 3901 Lemay Ferry Road, Saint Louis, MO 63125 | 2011-04-11 |
| 1093049694 | Lauren C Mensie | Psychologist | 1 Jefferson Barracks Dr., 116b/jb St. Louis Va Medical Center, St. Louis, MO 63125 | 2009-09-29 |
| Find all providers in zip 63125 | ||||
| Taxonomy Code | 152WC0802X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Corneal and Contact Management |
| The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508086166 | Marlin B Neil | Optometrist | 12312 Olive Blvd Ste 150, Saint Louis, MO 63141-5468 | 2007-04-26 |
| 1588722748 | Morio Miyamoto | Optometrist | 720 Olive St, Suite 420, Saint Louis, MO 63101-2338 | 2006-12-04 |
| 1295371946 | Pec South County LLC | Optometrist | 4412 Telegraph Rd, Saint Louis, MO 63129-3316 | 2019-11-18 |
| 1952725210 | Altenbernd Family Eye Care, LLC | Optometrist | 5445 Telegraph Rd, Suite 119, Saint Louis, MO 63129-3500 | 2014-02-06 |
| 1770664625 | Fontana Eyecare Associates, LLC. | Optometrist | 16 Hampton Village Plz, Suite 249, Saint Louis, MO 63109-2128 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114056231 | Kevin Greeley Lydon | Optometrist | 6764 Mexico Rd, Saint Peters, MO 63376-1505 | 2007-03-05 |
| 1184759284 | Ralph Melvin Butler | Optometrist | 401 Supercenter Dr, Walmart Vision Center, Jefferson City, MO 65101-8190 | 2007-02-22 |
| 1972645919 | Thomas Stanley Sandler | Optometrist | Jc Penney Optical, 4 Mid Rivers Mall Drive, St. Peters, MO 63376 | 2007-02-13 |
| 1811039910 | Rick Jon Unsell | Optometrist | 7436 Nw River Park Dr, Parkville, MO 64152-5028 | 2007-02-13 |
| 1659421303 | Ira Nathan Ettinger | Optometrist | 1701 Aroy Dr., Washington, MO 63090 | 2007-01-12 |
| 1578649547 | Lawrence Allen Aurich | Optometrist | 12420 So. 71 Highway, Grandview, MO 64030 | 2006-10-31 |
| 1093823924 | Jeffrey Donald Laferla | Optometrist | 8301 N Congress Ave, Kansas City, MO 64152-2041 | 2006-08-29 |
| 1356454060 | Frank Joseph Bier | Optometrist | 14037 Manchester Rd, Manchester, MO 63011-4513 | 2006-08-16 |
| 1548206576 | William H Gosnell | Optometrist | 17950 E 39th St S, Independence, MO 64055-3850 | 2006-06-20 |
| 1144262536 | Gerald Robert Gosnell | Optometrist | 4631 Wyandotte, Kansas City, MO 64112-1542 | 2006-06-12 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS |
| Zip Code | 63125 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.