Individual provider Active NPI

Emily Joanna Wang, OD

  • Optometrist
  • Dallas, TX
National Provider Identifier
1093453128
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10637 Issued in TX
Practice address
5330 E Mockingbird LN Ste 130
Dallas, TX 75206-0961
Phone
(214) 341-9955
NPI assigned
May 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 10637 TX Primary

Addresses

Primary practice location

5330 E Mockingbird LN Ste 130
Dallas, TX 75206-0961

Mailing address

5951 South Loop E Unit 52
Houston, TX 77033-1055
Phone (713) 992-2911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220907002350 TX Practitioner - Optometry 9537543798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

3636 McKinney Ave
Suite 120
Dallas, TX 75204-1443
Phone (214) 438-0248

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10637TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Texas Professional PLLC Optometrist CurrentSince Aug 1, 2022 Accepting new patients
Dallas Eyeworks Inc Optometrist PastSince Sep 2, 2010 Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients

Locations

111 E 4th St
Ste 440
Alton, IL 62002

3636 McKinney Ave
Ste 120
Dallas, TX 75204
Phone (214) 252-1800

5330 E Mockingbird Ln
Ste 130
Dallas, TX 75206
Phone (214) 341-9955

7324 Gaston Ave
Ste 310
Dallas, TX 75214
Phone (214) 660-9830

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

6850 N Shiloh Rd
Ste T
Garland, TX 75044
Phone (972) 414-0444

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1653609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1093453128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5951 SOUTH LOOP E UNIT 52",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770331055",
            "telephone_number": "713-992-2911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5330 E MOCKINGBIRD LN STE 130",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752060961",
            "telephone_number": "214-341-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "EMILY",
        "middle_name": "JOANNA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-27",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.