Active NPI
John A Canyon, O.D.
- Optometrist
- Killeen, TX
National Provider Identifier
1073784237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 02283
- Practice address
- 1400 Lowes Blvd
Killeen, TX 76542-5201 - Phone
- (254) 200-1165
- Fax
- (254) 634-1800
- NPI assigned
- Mar 17, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 02283 | TX | Primary |
Addresses
Primary practice location
1400 Lowes Blvd
Killeen, TX 76542-5201
Mailing address
PO Box 337
Henderson, TX 75653-0337
Phone (903) 854-2192
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2283 | TX | MD | Marriage & Family Therapist |
| 02283 | TX | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charles R Sanders | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Optometrist
- Killeen, TX
- NPI 1225210792
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205712000000",
"number": "1073784237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 337",
"city": "HENDERSON",
"state": "TX",
"postal_code": "756530337",
"telephone_number": "903-854-2192",
"fax_number": "903-854-2407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 LOWES BLVD",
"city": "KILLEEN",
"state": "TX",
"postal_code": "765425201",
"telephone_number": "254-200-1165",
"fax_number": "254-634-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANYON",
"first_name": "JOHN",
"middle_name": "A",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-17",
"last_updated": "2008-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "02283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Killeen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.