Active NPI
Hub Optical Distributing Co Inc
- Optometrist
- Waco, TX
National Provider Identifier
1164554903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3388T
- Legal business name
- HUB OPTICAL DISTRIBUTING CO INC
- Practice address
- 3713 Franklin Ave
Waco, TX 76710-7329 - Phone
- (254) 752-1081
- Fax
- (254) 752-1463
- NPI assigned
- Mar 9, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisa E Salganik
- Title
- Administrator
- Phone
- (254) 752-1081
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3388T | TX | Primary |
| Durable Medical Equipment & Medical Supplies | 332B00000X |
Addresses
Primary practice location
3713 Franklin Ave
Waco, TX 76710-7329
Mailing address
3713 Franklin Ave
Waco, TX 76710-7329
Phone (254) 752-1081
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 093145302 | Medicaid | TX | |
| TXB125858 | Other | TX | MEDICARE PTAN (PHYSICIAN) |
Other names 1
- The Optical Dispensary
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 2
National Provider Directory
National Provider Directory- Tax ID family
- Hub Optical Distributin
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Eyewear Supplier
- Waco, TX
- NPI 1942460480
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Athens, TX
- NPI 1275610289
-
- Optometrist
- Waco, TX
- NPI 1861524605
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173398400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1370304000000",
"number": "1164554903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3713 FRANKLIN AVE",
"city": "WACO",
"state": "TX",
"postal_code": "767107329",
"telephone_number": "254-752-1081",
"fax_number": "254-752-1463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3713 FRANKLIN AVE",
"city": "WACO",
"state": "TX",
"postal_code": "767107329",
"telephone_number": "254-752-1081",
"fax_number": "254-752-1463"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HUB OPTICAL DISTRIBUTING CO INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-09",
"last_updated": "2013-06-04",
"status": "A",
"authorized_official_last_name": "SALGANIK",
"authorized_official_first_name": "LISA",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "254-752-1081"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "TX",
"license": "3388T",
"primary": true
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "093145302",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN (PHYSICIAN)",
"identifier": "TXB125858",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "The Optical Dispensary",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; 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.