Active NPI
Charda P Bronaugh, OPTICIAN
- Optician
- Lufkin, TX
National Provider Identifier
1114976420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- Practice address
- 1607 W Frank Ave
Suite 109
Lufkin, TX 75904-3103 - Phone
- (936) 632-1010
- Fax
- (936) 632-3233
- NPI assigned
- May 6, 2006
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | Primary |
Addresses
Primary practice location
1607 W Frank Ave
Suite 109
Lufkin, TX 75904-3103
Mailing address
1607 W Frank Ave
Suite 109
Lufkin, TX 75904-3103
Phone (936) 632-1010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 086517201 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bronaugh Opticians | Optician | Past | Accepting new patients |
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.
-
- Optician
- Lufkin, TX
- NPI 1417207069
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260835200000",
"number": "1114976420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1607 W FRANK AVE",
"address_2": "SUITE 109",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043103",
"telephone_number": "936-632-1010",
"fax_number": "936-632-3233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1607 W FRANK AVE",
"address_2": "SUITE 109",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043103",
"telephone_number": "936-632-1010",
"fax_number": "936-632-3233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRONAUGH",
"first_name": "CHARDA",
"middle_name": "P",
"credential": "OPTICIAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-06",
"last_updated": "2009-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "086517201",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lufkin, TX
- Jordan Bridges
- Bright Beginnings Pediatrics PLLC
- William Albert Bright, M.D.
- Bronaugh Independent Opticians Inc.
- Bronaugh Opticians
- Brookshire Brothers Inc (Brookshire Brothers Pharmacy)
- Brookshire Brothers Inc (Brookshire Brothers Pharmacy)
- Brookshire Brothers Inc (Brookshire Brothers Pharmacy)
- Brookshire Brothers Inc
- Brookshire Brothers LTD (Brookshire Brothers Pharmacy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.