Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1770694762 Deactivated / Inactive NPI Male Practitioner

Dr. Edwin M. Pack , OD

Optometrist • Fort Worth, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Edwin Pack has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 31, 2006
NPI Deactivation Date December 07, 2017
Total Practice Duration ~11 Years of Practice (2006 – 2017)

Professional Overview & Biography Verified Profile Summary

Dr. Edwin Pack, OD was a registered Optometrist practicing in Fort Worth, TX. Throughout an active medical career spanning 11 years, Dr. Pack provided care at the practice location at 1217 OAK KNOLL DR until profile deactivation on 2017-12-07.

Practice Location & Contact Primary Location

Practice Address

1217 Oak Knoll Dr

Fort Worth, TX 761175505

Telephone 8178316141
Fax 6826473909
Associated Practice Facility / Clinic
🏢 Pack Optical Facility NPI 1154506822

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Fort Worth, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 15.3 Yrs
State Avg: 19.5 Yrs
Regional Practice Density
158 Specialists

Practicing in Fort Worth, TX (5156 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License TX 3718

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1568573574

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated December 07, 2017

Record deactivated on December 07, 2017

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1217 OAK KNOLL DR, FORT WORTH, TX 761175505 (Tel: 8178316141)

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Updated Business Mailing Address July 08, 2007

Registered at 1217 OAK KNOLL DR, FORT WORTH, TX 761175505 (Tel: 8178316141)

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Provider Name / Credentials Updated July 08, 2007

Recorded as EDWIN PACK, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Optometrist (License #3718 in TX)

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Initial NPI Registration & Enumeration August 31, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1770694762
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 31, 2006
Last Update: July 08, 2007
Deactivation Date: December 07, 2017

Mailing Address

1217 Oak Knoll Dr

Fort Worth, TX 761175505

Phone: 8178316141

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.