Individual provider Active NPI

Mike Earl Butaud, OPTICIAN

  • Optician
  • Jasper, TX
National Provider Identifier
1154599736
Registry record updated Feb 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Practice address
128 N Austin Street
Jasper, TX 75951
Phone
(409) 383-1120
NPI assigned
Feb 15, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X Primary

Addresses

Primary practice location

128 N Austin Street
Jasper, TX 75951

Mailing address

128 N Austin Street
Jasper, TX 75951
Phone (409) 383-1120

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

NPI Registry JSON

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1154599736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 N AUSTIN STREET",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "75951",
            "telephone_number": "409-383-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 N AUSTIN STREET",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "75951",
            "telephone_number": "409-383-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTAUD",
        "first_name": "MIKE",
        "middle_name": "EARL",
        "name_prefix": "Mr.",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.