Narin Petikun OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

NARIN PETIKUN OD PA

Practice address

621 Uptown Blvd
A
Cedar Hill, TX 75104-3508

Phone

(972) 293-7061

NPI assigned

Apr 25, 2007

Organization subpart

No

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

Authorized official

Name

Narin PetikunNPI 1538142526

Title

President

Phone

(972) 293-7061

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Narin Petikun, O.D.

  • Optometrist
  • Cedar Hill, TX
  • NPI 1538142526
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430179200000",
    "number": "1083833156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3652 EDEN DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752876261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 UPTOWN BLVD",
            "address_2": "A",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751043508",
            "telephone_number": "972-293-7061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NARIN PETIKUN OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2015-04-28",
        "status": "A",
        "authorized_official_last_name": "PETIKUN",
        "authorized_official_first_name": "NARIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-293-7061"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179131101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander Christopher Mullins
• Lynette Anderson Mullins
• Ahone Musong, PHARM D
• My Home DFW Mso LLC
• My Home MD Non Profit, Inc
• Cecil Leon Nash, RPH
• Agnelyne Afugmeyig Ndifor, DNP, PMHNP-BC
• Charnita Patrice Neely, NURSE PRACTITIONER
• Roxana Nelson
• Neo-Uz,LLC

• Optometrist in Cedar Hill, TX
• Providers in Cedar Hill, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.