Individual provider Active NPI

Stephen S Anderson, OD

  • Optometrist
  • Plano, TX
National Provider Identifier
1144634957
Registry record updated Jun 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8433T Issued in TX
Practice address
2313 W Parker Rd
Plano, TX 75023-7839
Phone
(972) 612-2015
NPI assigned
Jun 19, 2014
Last updated
Jun 19, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8433T TX Primary

Addresses

Primary practice location

2313 W Parker Rd
Plano, TX 75023-7839

Mailing address

2313 W Parker Rd
Plano, TX 75023-7839
Phone (972) 612-2015

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
I20141030001967 TX Practitioner - Optometry 0941421242 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8433TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy West Texas Eye Care Optometrist Current Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Oct 22, 2019 Accepting new patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Oct 22, 2019 Accepting new patients

Locations

2313 W Parker Rd
Plano, TX 75023
Phone (972) 612-2015

2703 Richmond Rd
Texarkana, TX 75503
Phone (903) 838-0783

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403136000000",
    "number": "1144634957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2313 W PARKER RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750237839",
            "telephone_number": "972-612-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2313 W PARKER RD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750237839",
            "telephone_number": "972-612-2015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "STEPHEN",
        "middle_name": "S",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8433T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.