Individual provider Active NPI

Lorraine Carol Suder, O.D.

  • Optometrist
  • Garland, TX
National Provider Identifier
1043324973
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3640T Issued in TX
Practice address
6850 N Shiloh Rd
Suite T
Garland, TX 75044-2912
Phone
(972) 414-0444
Fax
(972) 414-5663
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3640T TX Primary

Addresses

Primary practice location

6850 N Shiloh Rd
Suite T
Garland, TX 75044-2912

Mailing address

6850 N Shiloh Rd
Suite T
Garland, TX 75044-2912
Phone (972) 414-0444

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
I20080418000105 TX Practitioner - Optometry 6901984863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Waterloo - School of Optometry, 1986
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)

1437 Hwy 6
Suite 400
Sugar Land, TX 77478-5131
Phone (281) 265-9090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3640TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Texas Professional PLLC Optometrist CurrentSince Dec 14, 2020 Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients

Locations

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

6850 N Shiloh Rd
Garland, TX 75044
Phone (972) 496-4403

1437 Highway 6
Ste 400
Sugar Land, TX 77478
Phone (281) 265-9090

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186531200000",
    "number": "1043324973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 N SHILOH RD",
            "address_2": "SUITE T",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750442912",
            "telephone_number": "972-414-0444",
            "fax_number": "972-414-5663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 N SHILOH RD",
            "address_2": "SUITE T",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750442912",
            "telephone_number": "972-414-0444",
            "fax_number": "972-414-5663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDER",
        "first_name": "LORRAINE",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3640T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.