Mustang Optical, Inc.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

MUSTANG OPTICAL, INC.

Practice address

123 N Mustang Rd
Mustang, OK 73064-3912

Phone

(405) 376-0222

Fax

(405) 376-0233

NPI assigned

Jan 17, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Kennith D ButlerNPI 1942346150

Title

Owner

Phone

(405) 376-0222

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

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

• Kennith Butler

  • Optician
  • Mustang, OK
  • NPI 1942346150
  NPD Authorized official

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1104002328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 N MUSTANG RD",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730643912",
            "telephone_number": "405-376-0222",
            "fax_number": "405-376-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N MUSTANG RD",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730643912",
            "telephone_number": "405-376-0222",
            "fax_number": "405-376-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSTANG OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-17",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "KENNITH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-376-0222",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100769000A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mustang Drug LLC
• Mustang Family Dental
• Mustang Family Physicians PC
• Mustang Foot & Ankle Clinic, LLC
• Mustang Multispecialty Accociation
• Alayna Myers
• Narulas Healthcare LLC
• Soha Nasim
• Orlando Neal
• Jodie Leann Netherton

• Eyewear Supplier in Mustang, OK
• Providers in Mustang, OK by specialty
• Eyewear Supplier in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.