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NPI Code Detail

MEDICARE: ADELL ANN ELIZABETH WALTERS OD

MEDICARE: ADELL ANN ELIZABETH WALTERS OD
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
1152W00000XOptometrist002504AZ
2152W00000XOptometrist10513TX

General Provider Information

NPI Number : 1679143606
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADELL ANN ELIZABETH WALTERS OD
Provider Business Mailing Address
First Line : 8614 WESTWOOD CENTER DR FL 9
Second Line :
City : VIENNA
State : VA
Zip : 22182-2442
Country : US
Telephone Number : 703-847-8899
Fax Number : 571-223-6780
Provider Business Practice Location Address
First Line : 350 E INTERSTATE 20
Second Line :
City : ARLINGTON
State : TX
Zip : 76018-1119
Country : US
Telephone Number : 817-784-0222
Fax Number : 817-467-5819
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2021
Last Update Date : 03/23/2026

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