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Deactivated NPI 1497794192 Deactivated / Inactive NPI Male Practitioner

Dr. Spencer V Moore , OD

Optometrist • Waco, 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. Spencer Moore has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 06, 2006
NPI Deactivation Date March 29, 2023
Total Practice Duration ~17 Years of Practice (2006 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Spencer Moore, OD was a registered Optometrist practicing in Waco, TX. Throughout an active medical career spanning 17 years, Dr. Moore provided care at the practice location at 1215 LAKE AIR DR until profile deactivation on 2023-03-29.

Practice Location & Contact Primary Location

Practice Address

1215 Lake Air Dr

Waco, TX 767104419

Telephone 2547520471
Fax 2547570866
Associated Practice Facility / Clinic
🏢 Green Eye Associates, Pllc Facility NPI 1063833242

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Waco, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 16.6 Yrs
State Avg: 19.5 Yrs
Regional Practice Density
31 Specialists

Practicing in Waco, 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 2164TG

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

4 Associated Practitioners
Dr. Leigh Green , OD

Optometrist - Corneal and Contact Management

NPI 1447502166

Doctor of Optometry

NPI 1568956605

Doctor of Optometry

NPI 1609763135

Doctor of Optometry

NPI 1851975718

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 March 29, 2023

Record deactivated on March 29, 2023

NPI Profile Active May 23, 2013

NPI status registered as active in NPPES database

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Updated Practice Location May 23, 2013

Registered at 1215 LAKE AIR DR, WACO, TX 767104419 (Tel: 2547520471)

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Updated Business Mailing Address May 23, 2013

Registered at 1215 LAKE AIR DR, WACO, TX 767104419 (Tel: 2547520471)

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Provider Name / Credentials Updated May 23, 2013

Recorded as SPENCER MOORE, OD

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Medical Taxonomy / Specialty Registered (Primary Specialty) May 23, 2013

Optometrist (License #2164TG in TX)

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Initial NPI Registration & Enumeration June 06, 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: 1497794192
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 06, 2006
Last Update: May 23, 2013
Deactivation Date: March 29, 2023

Mailing Address

1215 Lake Air Dr

Waco, TX 767104419

Phone: 2547520471

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.