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Deactivated NPI 1912991415 Deactivated / Inactive NPI Male Practitioner

Dr. William Fan , OD

Optometrist • Plano, TX

✓ Accepts Medicare Assignment
⚠️

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. William Fan has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 12, 2005
NPI Deactivation Date March 25, 2006
Total Practice Duration ~13 Years of Practice (1993 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. William Fan, OD was a registered Optometrist in Plano, TX. Prior to record deactivation on 2006-03-25, Dr. Fan completed approximately 13 years of clinical practice following graduation from New England College Of Optometry in 1993.

Dr. Fan was affiliated with Med Southwest Pllc and accepted Medicare assignment.

Historical Medicare Part B clinical services included established patient complete exam of visual system. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

708 E 15th St Ste A

Plano, TX 750745774

Telephone 9725098555
Fax 9725098556
Associated Practice Facility / Clinic
🏢 Med Southwest, Pllc Facility NPI 1184519332

Medicare Profile & Education

Medical School

New England College Of Optometry

Graduation Year

1993

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Plano, TX

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
33 Yrs +14.7 yrs vs City Avg
City Avg: 18.3 Yrs
State Avg: 19.5 Yrs
Regional Practice Density
110 Specialists

Practicing in Plano, TX (5156 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
2.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Fan (33 Years) 33 Yrs
Plano Specialty Average (18.3 Years) 18.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2017)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92014 Established patient complete exam of visual system
12 12 $85.00 $82.76

Medical Specialties & State Licenses

CMS Verified: 2023-11-13
Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License TX 4925TG

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
157827001 (TX)

Hospital & Practice Group Affiliations

Med Southwest Pllc

625 W Dickey Rd, Grand Prairie, TX 750513129

Phone: 9722624391

Practice Associates & Co-Workers

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

1 Associated Practitioners
NPI 1669466348

Doctor of Optometry

Career & Practice History Timeline

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

10 Historical Events
📍
Updated Practice Location November 15, 2023

Registered at 708 E 15TH ST STE A, PLANO, TX 750745774 (Tel: 9725098555)

📍
Updated Business Mailing Address November 15, 2023

Registered at 708 E 15TH ST STE A, PLANO, TX 750745774 (Tel: 9725098555)

📍
Updated Business Mailing Address October 06, 2020

Registered at 1950 OLD GALLOWS RD STE 520, VIENNA, VA 221823970 (Tel: 7038478899)

📍
Updated Practice Location March 23, 2009

Registered at 625 W DICKEY RD, GRAND PRAIRIE, TX 750513129 (Tel: 9722624391)

📍
Updated Business Mailing Address March 23, 2009

Registered at 625 W DICKEY RD, GRAND PRAIRIE, TX 750513129 (Tel: 9722624391)

👤
Provider Name / Credentials Updated March 23, 2009

Recorded as WILLIAM FAN, O.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 23, 2009

Optometrist (License #4925TG in TX)

🔄
NPI Profile Reactivated March 30, 2006

Record officially reactivated for active practice on March 30, 2006

⚠️
NPI Profile Deactivated March 25, 2006

Record deactivated on March 25, 2006

🟢
Initial NPI Registration & Enumeration September 12, 2005

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: 1912991415
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 12, 2005
Last Update: November 15, 2023
Deactivation Date: March 25, 2006
Sole Proprietor: No

Mailing Address

708 E 15th St Ste A

Plano, TX 750745774

Phone: 9725098555

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.