Emmanuel Gbolabo

Primary specialty

OptometristTaxonomy code 152W00000X

License

11134 Issued in TX

Practice address

505 N Gun Barrel LN
Gun Barrel City, TX 75156-3732

Phone

(903) 887-7623

NPI assigned

Jun 4, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA, TX2 enrollments

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 2

Specialty

Optometry

Education

University of Houston - College of Optometry, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alexandria Eye and Laser Center LLCGroup PAC ID 4789641010, 24 clinicians

Arlington Ophthalmology Association PLLCGroup PAC ID 2668379876, 22 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• LA PPO C-SNP

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.

• Alexandria Eye and Laser Center, LLC

  • Ophthalmology Physician
  • Alexandria, LA
  • NPI 1538120985

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Arlington Ophthalmology Association PLLC

  • Clinic/Center
  • Arlington, TX
  • NPI 1639276843

  Optometrist

  Medicare reassignment Care Compare group NPD (past)
• Alexandria Eye and Laser Center, LLC

  • Eyewear Supplier
  • Oakdale, LA
  • NPI 1063285260
  NPD
• Alexandria Eye and Laser Center, LLC

  • Eyewear Supplier
  • Eunice, LA
  • NPI 1578336558
  NPD (past)

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1104667153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200438",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753200438",
            "telephone_number": "877-591-3106",
            "fax_number": "877-591-3106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N GUN BARREL LN",
            "city": "GUN BARREL CITY",
            "state": "TX",
            "postal_code": "751563732",
            "telephone_number": "903-887-7623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5494 Glen Lakes Dr",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752314308",
            "country_code": "US",
            "telephone_number": "214-692-6220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3645 Dallas Pkwy",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750938181",
            "country_code": "US",
            "telephone_number": "214-440-5201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GBOLABO",
        "first_name": "EMMANUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-04",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "11134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Step to Recovery LLC
• Marian H, Flowers, CCC SLP
• Diane Marilee Gard, PHD
• GBC Medical Associates PLLC
• GBC Orthodontics
• William Russell Giles Jr., MD
• Glen Haywood DC PC
• Marsha Gooch, LMT
• Aaron Edward Goswick
• Heather Michelle Green, CPM, LM

• Optometrist in Gun Barrel City, TX
• Providers in Gun Barrel City, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.