Idabel Teg LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

IDABEL TEG LLC

Practice address

2020 S E Washington
Idabel, OK 74745

Phone

(903) 329-5051

Fax

(903) 329-5053

NPI assigned

Oct 31, 2022

Organization subpart

No

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

Authorized official

Name

Kayla E Grassie

Title

Billing

Phone

(903) 329-5051

Specialties & licenses 1

Addresses

Other names 1

• The Eye Guys Doing business as

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670457600000",
    "number": "1104533009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 S E WASHINGTON",
            "city": "IDABEL",
            "state": "OK",
            "postal_code": "74745",
            "telephone_number": "903-329-5051",
            "fax_number": "903-329-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDABEL TEG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A",
        "authorized_official_last_name": "GRASSIE",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "903-329-5051"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Eye Guys",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Idabel, OK
• Eyewear Supplier in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.