Provider Demographics
NPI:1134102783
Name:SHEAR, MARK FITZGERALD (BS, OD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:FITZGERALD
Last Name:SHEAR
Suffix:
Gender:M
Credentials:BS, OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 HANBEE ST
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4508
Mailing Address - Country:US
Mailing Address - Phone:214-213-7997
Mailing Address - Fax:
Practice Address - Street 1:404 HANBEE ST
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-4508
Practice Address - Country:US
Practice Address - Phone:214-213-7997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4341TG152W00000X, 152WX0102X, 152WP0200X, 152WS0006X, 152WC0802X
OK2118152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU43737Medicare UPIN
TX00E72SMedicare PIN