Active NPI
Med Southwest, PLLC
Doing business as MyEyeDr.
- Optometrist
- Colleyville, TX
National Provider Identifier
1023837374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- MED SOUTHWEST, PLLC
- Doing business as
- MyEyeDr.
- Practice address
- 6114 Colleyville Blvd
Colleyville, TX 76034-6221 - Phone
- (817) 416-0333
- Fax
- (817) 416-0336
- NPI assigned
- Oct 4, 2024
- Last updated
- Oct 4, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sue Downes
- Title
- Secretary
- Phone
- (703) 847-8899
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | NU | Primary |
Addresses
Primary practice location
6114 Colleyville Blvd
Colleyville, TX 76034-6221
Mailing address
8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899
Other names 1
- MyEyeDr.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190221001481 | TX | Part B Supplier - Clinic/Group Practice | 4082952874 |
Receives reassigned benefits from 379 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Tax ID family
- Med Southwest PLLC
Organizations with this tax ID in the same state 15
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Optometrist
- Houston, TX
- NPI 1003760513
-
- Optometrist
- Fort Worth, TX
- NPI 1043166341
-
- Optometrist
- Angleton, TX
- NPI 1063367738
Locations
6114 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 416-0333
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1728000000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1728000000000",
"number": "1023837374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8614 WESTWOOD CENTER DR FL 9",
"city": "VIENNA",
"state": "VA",
"postal_code": "221822442",
"telephone_number": "703-847-8899",
"fax_number": "571-223-6780"
},
{
"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": {
"organization_name": "MED SOUTHWEST, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-10-04",
"last_updated": "2024-10-04",
"certification_date": "2024-10-04",
"status": "A",
"authorized_official_last_name": "DOWNES",
"authorized_official_first_name": "SUE",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "703-847-8899"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "MyEyeDr.",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Colleyville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.