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NPI Code Detail

MEDICARE: DR. MANUEL J DEBESA O.D.

MEDICARE: DR. MANUEL J DEBESA O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist3933TTX

General Provider Information

NPI Number : 1346354230
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MANUEL J DEBESA O.D.
Provider Business Mailing Address
First Line : 403 W OAK ST
Second Line :
City : WEATHERFORD
State : TX
Zip : 76086-4241
Country : US
Telephone Number : 817-594-0919
Fax Number : 817-594-0919
Provider Business Practice Location Address
First Line : 4000 E US HIGHWAY 377
Second Line :
City : GRANBURY
State : TX
Zip : 76049-7432
Country : US
Telephone Number : 817-573-7153
Fax Number : 817-573-5640
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2006
Last Update Date : 03/27/2025

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