Provider Demographics
NPI:1174811210
Name:NEIMAN, NOAH DANIEL (OD)
Entity type:Individual
Prefix:DR
First Name:NOAH
Middle Name:DANIEL
Last Name:NEIMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5717 BALCONES DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4203
Mailing Address - Country:US
Mailing Address - Phone:512-327-7000
Mailing Address - Fax:512-314-1662
Practice Address - Street 1:925 STARWOOD DR
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-9099
Practice Address - Country:US
Practice Address - Phone:512-327-7000
Practice Address - Fax:512-259-3802
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7816T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2859357-01Medicaid
TXTXB139572Medicare PIN