NPIMap

Organization Active NPI

Dr. Brettly J. Teague, LLC

Doing business as Big Country Eye Center

  • Ophthalmology Physician
  • Abilene, TX
National Provider Identifier
1083875934
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
J0305 Issued in TX
Legal business name
DR. BRETTLY J. TEAGUE, LLC
Doing business as
Big Country Eye Center
Practice address
4342 Treanor Dr
Abilene, TX 79602-7012
Phone
(325) 673-0900
NPI assigned
Jun 23, 2008
Last updated
Feb 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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

Authorized official

Name
Dr. Brett Teague, M.D.
Title
Owner
Phone
(325) 673-0900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7227TG TX
Ophthalmology Physician 207W00000X J0305 TX Primary

Addresses

Primary practice location

4342 Treanor Dr
Abilene, TX 79602-7012

Mailing address

4342 Treanor Dr
Abilene, TX 79602-7012
Phone (325) 673-0900

Other names 1

  • Big Country Eye Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080814000366 TX Part B Supplier - Clinic/Group Practice 1153496849 Receives reassigned benefits from 5 practitioners
Practice locations: Abilene, TX

National Provider Directory

National Provider Directory

Locations

4342 Treanor Dr
Abilene, TX 79602
Phone (325) 673-0900

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297209600000",
    "number": "1083875934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4342 TREANOR DR",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796027012",
            "telephone_number": "325-673-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4342 TREANOR DR",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796027012",
            "telephone_number": "325-673-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. BRETTLY J. TEAGUE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "last_updated": "2011-02-09",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "325-673-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7227TG",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "J0305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Big Country Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; 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.