DR. DAN A WILLIS (NPI# 1497792089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497792089 |
| Entity Type | Individual |
| Full Name | DR. DAN A WILLIS |
| Credential | MD |
| Practice Address |
1000 9th Ave Ste. B Fort Worth TX 76104-3906 |
| Mailing Address |
1650 W Rosedale St Ste 200 Fort Worth TX 76104-7426 |
| Practice Telephone | 8178775381 |
| Practice Fax Number | 8178773992 |
| Mailing Telephone | 8178775381 |
| Mailing Fax Number | 8178773992 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2018-06-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | E2944 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 113953703 | 05 | |
| TX | 113953701 | 05 |
| Street Address |
1000 9TH AVE STE. B |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-3906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629604111 | Jacklyn Michelle Platt | Registered Nurse | 1000 9th Ave, Fort Worth, TX 76104-3906 | 2020-03-17 |
| 1275741464 | Travis Wolfe Crudup | Surgery | 1000 9th Ave, Fort Worth, TX 76104-3906 | 2007-05-19 |
| 1538234265 | Mary Biasiolli | Registered Nurse | 1000 9th Ave, Fort Worth, TX 76104-3906 | 2006-11-21 |
| 1184641797 | Mark F. Collins | Surgery | 1000 9th Ave, Fort Worth, TX 76104-3906 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962050492 | Precision Ambulatory Surgery Center, LLC | Ophthalmology | 9439 North Beach Street, Fort Worth, TX 76244 | 2019-08-28 |
| 1538450721 | Kim-binh Thi Mai | Ophthalmology | 3824 N Tarrant Pkwy Ste 310, Fort Worth, TX 76244-5431 | 2011-04-22 |
| 1063720654 | Texas Health Care, P.l.l.c. | Ophthalmology | 4950 Overton Ridge Blvd., Fort Worth, TX 76132-1909 | 2010-09-17 |
| 1023336633 | Taylor Boyd Strange | Ophthalmology | 4501 Heritage Trace Pkwy, Suite 121, Fort Worth, TX 76244-8940 | 2010-05-06 |
| 1649418831 | Dan A. Willis, M.d., P.a. | Ophthalmology | 1325 Pennsylvania Ave Ste 670, Fort Worth, TX 76104-2133 | 2009-01-27 |
| 1679630131 | Texas Health Care, P.l.l.c. | Ophthalmology | 4932 Overton Ridge, Fort Worth, TX 76132-0000 | 2007-01-03 |
| 1043237647 | Harry Rosenthal Jr. | Ophthalmology | 4932 Overton Ridge Blvd, Fort Worth, TX 76132-1909 | 2006-07-17 |
| 1528009214 | Harold Granek Mdpa | Ophthalmology | 1021 Washington Ave, Fort Worth, TX 76104-3021 | 2006-06-10 |
| 1861456584 | Judson P Smith IIi | Ophthalmology | 417 W Magnolia Ave, Fort Worth, TX 76104 | 2006-04-12 |
| 1154301372 | Michael Griffin Hunt | Ophthalmology | 321 S Henderson St, Fort Worth, TX 76104-1016 | 2006-01-23 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
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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.