Organization Active NPI

Jose N. Garica-Davalos MD

Doing business as Laredo Medical Optical

  • Eyewear Supplier
  • Laredo, TX
National Provider Identifier
1053443770
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
JOSE N. GARICA-DAVALOS MD
Doing business as
Laredo Medical Optical
Practice address
6416 Polaris Dr Ste 101
Laredo, TX 78041-2088
Phone
(956) 791-2023
Fax
(956) 791-0144
NPI assigned
Mar 9, 2007
Organization subpart
Yes
Parent organization
JOSE N. GARCIA-DAVALOS MDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Authorized official

Name
Dr. Jose N Garcia-Davalos, M.D.
Title
Ophthalmologist
Phone
(956) 791-2023

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

6416 Polaris Dr Ste 101
Laredo, TX 78041-2088

Mailing address

6416 Polaris Dr Ste 1
Laredo, TX 78041-2089
Phone (956) 791-2023

Other identifiers 1

IdentifierTypeStateIssuer
154509701MedicaidTX

Other names 1

  • LAREDO MEDICAL OPTICAL Doing business as

National Provider Directory

National Provider Directory
Part of
Jose N Garica-Davalos MD

Locations

6416 Polaris Dr
Ste 1
Laredo, TX 78041

6262 McPherson Rd
Ste 101
Laredo, TX 78041

6416 Polaris Dr
Ste 101
Laredo, TX 78041
Phone (956) 791-2023

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734048000000",
    "number": "1053443770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6416 POLARIS DR STE 1",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780412089",
            "telephone_number": "956-791-2023",
            "fax_number": "956-791-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6416 POLARIS DR STE 101",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780412088",
            "telephone_number": "956-791-2023",
            "fax_number": "956-791-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSE N. GARICA-DAVALOS MD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOSE N. GARCIA-DAVALOS MD",
        "enumeration_date": "2007-03-09",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "GARCIA-DAVALOS",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "956-791-2023",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154509701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAREDO MEDICAL OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LAREDO MEDICAL OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.