NPIMap

Organization Active NPI

Costco Wholesale Corporation

Doing business as Costco Optical #489

  • Eyewear Supplier
  • Fort Worth, TX
National Provider Identifier
1013308725
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
CP20045 Issued in TX
Legal business name
COSTCO WHOLESALE CORPORATION
Doing business as
Costco Optical #489
Practice address
5300 Overton Ridge Blvd
Fort Worth, TX 76132-3301
Phone
(817) 210-0003
Fax
(817) 210-0005
NPI assigned
Feb 17, 2015
Last updated
Mar 4, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
COSTCO WHOLESALE CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Authorized official

Name
Art Salas
Title
Avp Optical
Phone
(817) 210-0003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X CP20045 TX Primary

Addresses

Primary practice location

5300 Overton Ridge Blvd
Fort Worth, TX 76132-3301

Mailing address

PO Box 35005
Seattle, WA 98124-3405
Phone (425) 313-8100

Other names 1

  • Costco Optical #489 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Costco Pharmacy 1411,511 organizations share this tax ID, including this one
Part of
Costco Pharmacy 141

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1424131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1013308725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35005",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981243405",
            "telephone_number": "425-313-8100",
            "fax_number": "425-313-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 OVERTON RIDGE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761323301",
            "telephone_number": "817-210-0003",
            "fax_number": "817-210-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSTCO WHOLESALE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COSTCO WHOLESALE CORPORATION",
        "enumeration_date": "2015-02-17",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "SALAS",
        "authorized_official_first_name": "ART",
        "authorized_official_title_or_position": "AVP OPTICAL",
        "authorized_official_telephone_number": "817-210-0003"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "TX",
            "license": "CP20045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Costco Optical #489",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Costco Optical #489",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.