Organization Active NPI

Eldorado Vision & Optical, PLLC

  • Optometrist
  • McKinney, TX
National Provider Identifier
1154702223
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3932TG Issued in TX
Legal business name
ELDORADO VISION & OPTICAL, PLLC
Practice address
7785 Eldorado Pkwy Ste 400
McKinney, TX 75070-5615
Phone
(214) 914-6860
NPI assigned
Jun 15, 2015
Last updated
Jun 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Authorized official

Name
Mrs. Patti D Bushnell
Title
Practice Manager
Phone
(972) 672-1534

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3932TG TX Primary

Addresses

Primary practice location

7785 Eldorado Pkwy Ste 400
McKinney, TX 75070-5615

Mailing address

7785 Eldorado Pkwy Ste 400
McKinney, TX 75070-5615
Phone (214) 914-6860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160104001371 TX Part B Supplier - Clinic/Group Practice 4981906286 Receives reassigned benefits from 2 practitioners
Practice locations: McKinney, TX

National Provider Directory

National Provider Directory

Locations

7785 Eldorado Pkwy
Ste 400
McKinney, TX 75070
Phone (214) 914-6860

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1154702223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7785 ELDORADO PKWY STE 400",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750705615",
            "telephone_number": "214-914-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7785 ELDORADO PKWY STE 400",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750705615",
            "telephone_number": "214-914-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDORADO VISION & OPTICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "BUSHNELL",
        "authorized_official_first_name": "PATTI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "972-672-1534",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3932TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.