Provider Demographics
NPI:1386622330
Name:WEISSMAN, ALAN MARTIN (OD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:MARTIN
Last Name:WEISSMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 E TRINITY MILLS RD
Mailing Address - Street 2:SUITE 173
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-2545
Mailing Address - Country:US
Mailing Address - Phone:972-416-1270
Mailing Address - Fax:972-416-4839
Practice Address - Street 1:2810 E TRINITY MILLS RD
Practice Address - Street 2:SUITE 173
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-2545
Practice Address - Country:US
Practice Address - Phone:972-416-1270
Practice Address - Fax:972-416-4839
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3237 T G152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT16542Medicare UPIN
TX80051EMedicare PIN