Robertson Ocular Watters Creek LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

7583T Issued in TX

Legal business name

ROBERTSON OCULAR WATTERS CREEK LLC

Practice address

918 Watters Creek Blvd
Allen, TX 75013-3734

Phone

(214) 495-0095

Fax

(214) 785-6651

NPI assigned

Jul 16, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Reid Andrew Robertson, O.D.NPI 1306159520

Title

President

Phone

(214) 495-0095

Specialties & licenses 1

Addresses

Other names 1

• TSO Allen Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

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

• Reid Andrew Robertson, O.D.

  • Optometrist
  • Allen, TX
  • NPI 1306159520
  Medicare reassignment Care Compare group NPD Authorized official
• Shane Lucas Tibiletti, OD

  • Optometrist
  • Hurst, TX
  • NPI 1639721392
  Medicare reassignment Care Compare group NPD
• Nathan Dirks, O.D.

  • Optometrist
  • Lucas, TX
  • NPI 1477953172
  NPD (past)

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1093028219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 W BETHANY DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133739",
            "telephone_number": "214-495-0095",
            "fax_number": "214-785-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 WATTERS CREEK BLVD",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133734",
            "telephone_number": "214-495-0095",
            "fax_number": "214-785-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERTSON OCULAR WATTERS CREEK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-16",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "REID",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-495-0095",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7583T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TSO Allen",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TSO Allen",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Miranda Roach
• Robert Hughes Millwee, IV, MD
• Robert Scott Darrow, M.D., P.a.
• Amber Roberts, PT
• Angela Roberts, RPH
• Breanna M Robertson, LPC
• Fatima Robertson, DDS
• Reid Andrew Robertson, O.D.
• Madison Marie Robinette
• Jace Robinson, COTA

• Optometrist in Allen, TX
• Providers in Allen, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.