Individual provider Active NPI

Xinmian Lo, O.D

  • Optometrist
  • Dallas, TX
National Provider Identifier
1114006954
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5781T Issued in TX
Practice address
16731 Coit Rd
Dallas, TX 75248-1750
Phone
(972) 250-3500
NPI assigned
Nov 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5781T TX Primary

Addresses

Primary practice location

16731 Coit Rd
Dallas, TX 75248-1750

Mailing address

5409 Channel Isle Dr
Plano, TX 75093-4816
Phone (469) 619-5019

Other identifiers 1

IdentifierTypeStateIssuer
204717OtherTXCOLE MANAGED CARE

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
I20180529000771 TX Practitioner - Optometry 4789949587 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5781TXMDChiropractor
5781TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Eye Associates, P.a CurrentSince May 1, 2018 Accepting new patients

Locations

4122 LBJ
Ste 120
Farmers Branch, TX 75244
Phone (972) 392-0884

Organizations & group practices 1

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": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1114006954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5409 CHANNEL ISLE DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750934816",
            "telephone_number": "469-619-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16731 COIT RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481750",
            "telephone_number": "972-250-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LO",
        "first_name": "XINMIAN",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5781T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLE MANAGED CARE",
            "identifier": "204717",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.