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General NPI Number Information
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NPI Number | 1346354230
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Entity Type | Individual
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Provider Name | MANUEL J DEBESA O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 4000 E US HIGHWAY 377
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City | GRANBURY
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State | TX
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Zip | 76049-7432
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Country | US
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Telephone | 817-573-7153
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Fax | 817-573-5640
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Provider Business Mailing Address
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Address Line | 403 W OAK ST
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City | WEATHERFORD
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State | TX
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Zip | 76086-4241
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Country | US
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Telephone | 817-594-0919
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Fax | 817-594-0919
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3933T
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License Number State | TX
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