Provider Demographics
NPI:1174648141
Name:PLANTY, TIMOTHY FRANCES (OD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:FRANCES
Last Name:PLANTY
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 1:13427 EAST FREEWAY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-5901
Mailing Address - Country:US
Mailing Address - Phone:713-450-2020
Mailing Address - Fax:713-451-3937
Practice Address - Street 1:13427 EAST FREEWAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-5901
Practice Address - Country:US
Practice Address - Phone:713-450-2020
Practice Address - Fax:713-451-3937
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2630T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121639202Medicaid
TX827-16EMedicare ID - Type Unspecified