Active NPI
Joe R Putman, O.D
- Optometrist
- Arlington, TX
National Provider Identifier
1023088192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2193TG
- Practice address
- 3703 W Green Oaks Blvd
Arlington, TX 76016-3328 - Phone
- (817) 496-6022
- Fax
- (817) 496-8911
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2193TG | TX | Primary |
Addresses
Primary practice location
3703 W Green Oaks Blvd
Arlington, TX 76016-3328
Mailing address
3703 W Green Oaks Blvd
Arlington, TX 76016-3328
Phone (817) 496-6022
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0A4688 | Other | TX | MEDICARE GROUP PTAN |
| P00748760 | Other | TX | MEDICARE RAILROAD |
| 0934861 02 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2193TG | TX | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arlington Vision Source PC | Optometrist | Past | Accepting new patients |
| Oak Cliff Eye Clinic PLLC | Past | Accepting new patients |
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.
-
- Optometrist
- Arlington, TX
- NPI 1740773795
-
- Ophthalmology Physician
- Dallas, TX
- NPI 1235430299
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257984000000",
"number": "1023088192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3703 W GREEN OAKS BLVD",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760163328",
"telephone_number": "817-496-6022",
"fax_number": "817-496-8911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3703 W GREEN OAKS BLVD",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760163328",
"telephone_number": "817-496-6022",
"fax_number": "817-496-8911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUTMAN",
"first_name": "JOE",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "O.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-23",
"last_updated": "2009-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "2193TG",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP PTAN",
"identifier": "0A4688",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00748760",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0934861 02",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Arlington, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.