Active NPI
Crystal Varela, OD
- Optometrist
- Davie, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 129121629934
- Practice address
- 3200 S University Dr BLDG 1402
Davie, FL 33328-2018 - Phone
- (954) 262-4335
- Fax
- (954) 262-3904
- NPI assigned
- Jul 4, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 129121629934 | UT | Primary |
Addresses
Primary practice location
3200 S University Dr BLDG 1402
Davie, FL 33328-2018
Mailing address
PO Box 290370
Davie, FL 33329-0370
Phone (954) 262-4397
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10686 | TX | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 129121629934 | UT | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Modern Optometry PLLC | Optometrist | Current | Accepting new patients |
| Nova Southeastern University, Inc | Past | Accepting new patients |
Locations
6301 NW Loop 410
Ste 21A
San Antonio, TX 78238
Phone (210) 680-6097
5535 W Loop 1604 N
Ste 104
San Antonio, TX 78253
Phone (210) 415-4230
7400 San Pedro Ave
Ste 486A
San Antonio, TX 78216
Phone (210) 541-0008
6301 NW Loop 410
San Antonio, TX 78238
Phone (210) 523-4068
15900 La Cantera Pkwy
Ste 6697
San Antonio, TX 78256
Phone (210) 694-4110
Organizations & group practices 2
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.
-
- Optometrist
- San Antonio, TX
- NPI 1427735414
-
- Family Medicine Physician
- Davie, FL
- NPI 1447345517
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656892800000",
"number": "1114650538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 290370",
"city": "DAVIE",
"state": "FL",
"postal_code": "333290370",
"telephone_number": "954-262-4397",
"fax_number": "954-262-2269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 S UNIVERSITY DR BLDG 1402",
"city": "DAVIE",
"state": "FL",
"postal_code": "333282018",
"telephone_number": "954-262-4335",
"fax_number": "954-262-3904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARELA",
"first_name": "CRYSTAL",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-04",
"last_updated": "2022-07-04",
"certification_date": "2022-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "UT",
"license": "129121629934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.