Modern Spectacle Eyecare PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MODERN SPECTACLE EYECARE PLLC

Practice address

6336 Gaston Ave
Dallas, TX 75214-3926

Phone

(469) 225-9959

Fax

(469) 225-3537

NPI assigned

Oct 26, 2023

Last updated

Apr 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephanie Lesage, ODNPI 1568803419

Title

Optometrist

Phone

(713) 732-6385

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

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.

• Stephanie Kim Lesage, OD

  • Optometrist
  • Dallas, TX
  • NPI 1568803419
  Medicare reassignment NPD Authorized official
• Farid Samadzada, DC

  • Chiropractor
  • Dallas, TX
  • NPI 1558391797
  NPD (past)

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

{
    "created_epoch": "1698278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1164294807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6336 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752143926",
            "telephone_number": "469-225-9959",
            "fax_number": "469-225-3537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6336 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752143926",
            "telephone_number": "469-225-9959",
            "fax_number": "469-225-3537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN SPECTACLE EYECARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-26",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "LESAGE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "713-732-6385",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Modern Healthcare Services (Modern Home Health Agency)
• Modern Male T-Clinic, P.a.
• Modern Pi LLC (Namona)
• Modern Research Associates PLLC
• Modern Senior Living LLC (South Dallas Nursing and Rehabilitation)
• Jacob Samuel Modesitt
• Bijal J Modi, M.D.
• Dhruvangkumar Arunchandra Modi, M.D., M.P.H
• Kinnari Modi, DO
• Anna Kathryn Modisett, MD

• Optometrist in Dallas, TX
• Providers in Dallas, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.