Individual provider Active NPI

Gerardo Saldana Jr., O.D.

  • Optometrist
  • Nacogdoches, TX
National Provider Identifier
1164411195
Registry record updated Dec 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
06253TG Issued in TX
Practice address
3208 N University Dr
Nacogdoches, TX 75965-2633
Phone
(936) 564-7661
Fax
(936) 564-6622
NPI assigned
Oct 21, 2005
Last updated
Dec 23, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 06253TG TX Primary

Addresses

Primary practice location

3208 N University Dr
Nacogdoches, TX 75965-2633

Mailing address

PO Box 632600
Nacogdoches, TX 75963-2600
Phone (936) 564-7661

Other identifiers 2

IdentifierTypeStateIssuer
154278902MedicaidTX
06253TGOtherTXTX LICENSE

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
I20100915000411 TX Practitioner - Optometry 3779608617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nacogdoches Eye Associates, PLLCGroup PAC ID 2567647613, 4 clinicians

Practice addresses (Care Compare)

3208 N University Dr
Suite B
Nacogdoches, TX 75965-2634
Phone (936) 564-7661

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06253TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nacogdoches Eye Associates, PLLC Optometrist CurrentSince Feb 1, 2011 Accepting new patients
Mark Lanier OD PC Optometrist Past Accepting new patients
Aeg Texas Professional PLLC Optometrist Past Accepting new patients
Valley Eye Center PA Optometrist Past Accepting new patients

Locations

3208 N University Dr
Nacogdoches, TX 75965
Phone (936) 564-3937

3208 N University Dr
Ste B
Nacogdoches, TX 75965
Phone (936) 564-7661

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": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293062400000",
    "number": "1164411195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632600",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759632600",
            "telephone_number": "936-564-7661",
            "fax_number": "936-564-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3208 N UNIVERSITY DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759652633",
            "telephone_number": "936-564-7661",
            "fax_number": "936-564-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALDANA",
        "first_name": "GERARDO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2010-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "06253TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154278902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX LICENSE",
            "identifier": "06253TG",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

Verify at the official NPI Registry.