Provider Demographics
NPI:1497277792
Name:CACERES, DAVID ISAAC (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ISAAC
Last Name:CACERES
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 1:4101 S COOPER ST STE 107
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-4142
Mailing Address - Country:US
Mailing Address - Phone:817-472-0001
Mailing Address - Fax:
Practice Address - Street 1:4101 S COOPER ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-4159
Practice Address - Country:US
Practice Address - Phone:817-472-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-09
Last Update Date:2017-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9189T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist