Concord Optical

Primary specialty

OpticianTaxonomy code 156FX1800X

License

5767 Issued in MA

Legal business name

CONCORD OPTICAL

Practice address

80 Thoreau St
Concord, MA 01742-2409

Phone

(978) 369-6707

Fax

(978) 369-1880

NPI assigned

May 22, 2007

Last updated

Aug 8, 2008By 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

Mr. George Joseph Bourque II, L.D.O.

Title

Eyeglass Czar

Phone

(978) 369-6707

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1174732127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 THOREAU ST",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422409",
            "telephone_number": "978-369-6707",
            "fax_number": "978-369-1880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 THOREAU ST",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017422409",
            "telephone_number": "978-369-6707",
            "fax_number": "978-369-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORD OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "BOURQUE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "EYEGLASS CZAR",
        "authorized_official_telephone_number": "978-369-6707",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "L.D.O."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "MA",
            "license": "5767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Concord Dental Care, P.C.
• Concord Ekg Associates
• Concord Insight Partners, LLC
• Concord Internal Medicine Associates, P.C.
• Concord OB/GYN Associates PC
• Concord Optical Company Inc
• Concord Orthodontics PLLC (Heart Orthodontics)
• Concord Orthopedics, Inc
• Concord Pharmacy Inc (West Concord Pharmacy)
• Concord Plastic Surgery Inc

• Optician in Concord, MA
• Providers in Concord, MA by specialty
• Optician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.