Individual provider Active NPI

Mark Aaron Ruiz, O.D.

  • Optometrist
  • Garland, TX
National Provider Identifier
1053303339
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5317TG Issued in TX
Practice address
1821 Old Mill Run
Garland, TX 75042-4214
Phone
(972) 494-2020
Fax
(972) 276-5664
NPI assigned
Aug 22, 2005
Last updated
Jan 13, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5317TG TX Primary

Addresses

Primary practice location

1821 Old Mill Run
Garland, TX 75042-4214

Mailing address

1821 Old Mill Run
Garland, TX 75042-4214
Phone (972) 494-2020

Other identifiers 1

IdentifierTypeStateIssuer
0192916 01MedicaidTX

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
I20100819001199 TX Practitioner - Optometry 5597899922 Reassigns benefits to 1 organization
Practice locations: Garland, TX

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1821 Old Mill Run
Garland, TX 75042-4214
Phone (972) 494-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5317TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
James a Williams, OD, PC Optometrist CurrentSince Jun 25, 2014 Accepting new patients
James a Williams O.D.P.C. Current Accepting new patients
James a. Williams O.D.P.C. CurrentSince Jun 25, 2014 Accepting new patients

Locations

120 Town Pl
Fairview, TX 75069
Phone (972) 549-4255

2601 Preston Rd
Ste 2124
Frisco, TX 75034
Phone (972) 335-9332

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294876800000",
    "number": "1053303339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 OLD MILL RUN",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750424214",
            "telephone_number": "972-494-2020",
            "fax_number": "972-276-5664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 OLD MILL RUN",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750424214",
            "telephone_number": "972-494-2020",
            "fax_number": "972-276-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "MARK",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2011-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5317TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0192916 01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.