Organization Active NPI

Hub Optical Distributing Co Inc

  • Optometrist
  • Waco, TX
National Provider Identifier
1164554903
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3388T Issued in TX
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

Updated by the provider on Jun 4, 2013

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)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
093145302MedicaidTX
TXB125858OtherTXMEDICARE PTAN (PHYSICIAN)

Other names 1

  • The Optical Dispensary Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080624000716 TX Part B Supplier - Clinic/Group Practice 2961573662 Receives reassigned benefits from 2 practitioners
Practice locations: Waco, TX
O20100930052732 TX DME Supplier - Physician - OptometristDME Supplier - Optician 2961573662 Practice locations: Waco, TX

National Provider Directory

National Provider Directory
Tax ID family
Hub Optical Distributin2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.

Verify at the official NPI Registry.