NPIMap

Organization Active NPI

Daniel Max & Marcandrea LLC

Doing business as My EyeLab

  • Eyewear Supplier
  • Fort Worth, TX
National Provider Identifier
1053879569
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
DANIEL MAX & MARCANDREA LLC
Doing business as
My EyeLab
Practice address
501 Alta Mere Dr Ste 1021
Fort Worth, TX 76114-4014
Phone
(817) 502-6330
Fax
(561) 828-8367
NPI assigned
Mar 5, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Authorized official

Name
Jackie Bennett
Title
Credentialing Manager
Phone
(561) 612-4531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

501 Alta Mere Dr Ste 1021
Fort Worth, TX 76114-4014

Mailing address

3801 S Congress Ave
Palm Springs, FL 33461-4140
Phone (561) 275-2020

Other names 1

  • My EyeLab Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Daniel Max Marcandrea LLC108 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

501 Alta Mere Dr
Ste 1021
Fort Worth, TX 76114
Phone (817) 502-6330

NPI Registry JSON

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613692800000",
    "number": "1053879569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 S CONGRESS AVE",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334614140",
            "telephone_number": "561-275-2020",
            "fax_number": "561-275-2030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 ALTA MERE DR STE 1021",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761144014",
            "telephone_number": "817-502-6330",
            "fax_number": "561-828-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL MAX & MARCANDREA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-05",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "561-612-4531"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My EyeLab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.