Physician Compare National (NPI:1194722082)

HEALTHCARE PROVIDER: DONALD DEAN DERRYBERRY JR. O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1194722082
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4284709585
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090409000466
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DERRYBERRY
	Individual professional last name
Provider First Name	DONALD
	Individual professional first name
Provider Middle Name	D
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF HOUSTON - COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1991
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	18170 DALLAS PKWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 402
	Group Practice or individual's line 2 address
City	DALLAS
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	752877151
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y