Randall David Elliott, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4457TG Issued in TX

Practice address

11850 Wurzbach Rd
San Antonio, TX 78230-2744

Phone

(210) 492-4101

Fax

(210) 492-5623

NPI assigned

Aug 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Southern College of Optometry, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053422030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11850 WURZBACH RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782302744",
            "telephone_number": "210-492-4101",
            "fax_number": "210-492-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11850 WURZBACH RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782302744",
            "telephone_number": "210-492-4101",
            "fax_number": "210-492-5623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "RANDALL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4457TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lamar D Elliott, LCSW
• Laura Even Elliott, MD
• Meredith Elyse Elliott
• Michael Lee Elliott Jr.
• Morgan Claire Stanley Elliott, MD
• Steven Thomas Elliott, P.T.
• Symone Elliott, LVN
• Andrea Deno Ellis, M.A., L.P.C
• Angela Y Ellis, PMHNP-BC
• Brenna D. Ellis, MS,ATC,LAT

• Optometrist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.