Individual provider Active NPI

Alycia N Green, O.D.

  • Optometrist
  • Colleyville, TX
National Provider Identifier
1003914524
Registry record updated Sep 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6024T Issued in TX
Practice address
6114 Colleyville Blvd
Colleyville, TX 76034-6221
Phone
(817) 416-0333
Fax
(817) 416-0336
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6024T TX Primary

Addresses

Primary practice location

6114 Colleyville Blvd
Colleyville, TX 76034-6221

Mailing address

1650 N Lake Forest Dr
Ste 100
McKinney, TX 75071-7668
Phone (817) 416-0333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081204000099 TX Practitioner - Optometry 7315008737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

541 E Sandy Lake Rd
Coppell, TX 75019-3090
Phone (972) 393-3937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6024TTXMDOptometrist

Practice roles (2 of 5)

OrganizationSpecialtyStatusNew patients
Aeg Texas Professional PLLC Optometrist CurrentSince Dec 14, 2020 Accepting new patients
Aeg 7 TX Professional, PLLC Optometrist PastSince Feb 11, 2024 Accepting new patients

Locations

541 E Sandy Lake Rd
Coppell, TX 75019
Phone (972) 393-3937

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

6850 N Shiloh Rd
Ste T
Garland, TX 75044
Phone (972) 414-0444

670 E Southlake Blvd
Southlake, TX 76092
Phone (817) 329-6466

Networks

  • TX HMO
  • TX HMO D-SNP
  • NM HMO C-SNP

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505865600000",
    "number": "1003914524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 N LAKE FOREST DR",
            "address_2": "STE 100",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750717668",
            "telephone_number": "817-416-0333",
            "fax_number": "817-416-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6114 COLLEYVILLE BLVD",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760346221",
            "telephone_number": "817-416-0333",
            "fax_number": "817-416-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "ALYCIA",
        "middle_name": "N",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2017-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6024T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colleyville, TX

Sources for this page

Verify at the official NPI Registry.