Organization Active NPI

Bryan Total Vision Care

  • Optometrist
  • Bryan, TX
National Provider Identifier
1023265196
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BRYAN TOTAL VISION CARE
Practice address
2200 Briarcrest Dr
Ste 106
Bryan, TX 77802-5001
Phone
(979) 774-5400
Fax
(979) 731-8483
NPI assigned
Aug 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Authorized official

Name
Daniel R Vanlaningham, O.D.NPI 1528149374
Title
Vice President
Phone
(979) 774-5400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TX Primary

Addresses

Primary practice location

2200 Briarcrest Dr
Ste 106
Bryan, TX 77802-5001

Mailing address

2200 Briarcrest Dr
Ste 106
Bryan, TX 77802-5001
Phone (979) 774-5400

Other identifiers 1

IdentifierTypeStateIssuer
156519401MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120423000376 TX Part B Supplier - Clinic/Group Practice 9335300193 Receives reassigned benefits from 2 practitioners
Practice locations: Bryan, TX

National Provider Directory

National Provider Directory

Locations

2200 Briarcrest Dr
Ste 106
Bryan, TX 77802
Phone (979) 774-5400

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721952000000",
    "number": "1023265196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BRIARCREST DR",
            "address_2": "STE 106",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025001",
            "telephone_number": "979-774-5400",
            "fax_number": "979-731-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BRIARCREST DR",
            "address_2": "STE 106",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025001",
            "telephone_number": "979-774-5400",
            "fax_number": "979-731-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN TOTAL VISION CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-20",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A",
        "authorized_official_last_name": "VANLANINGHAM",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "979-774-5400",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156519401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.