Active NPI
Sue Jin Chong, O.D.
- Optometrist
- Irving, TX
National Provider Identifier
1174756142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 7433
- Practice address
- 204 S Nursery Rd
Ste 168
Irving, TX 75060-3184 - Phone
- (972) 579-4646
- NPI assigned
- Aug 25, 2009
- Last updated
- Nov 29, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 7433 | TX | Primary |
| Optometrist | 152W00000X | 2634 | OK |
Addresses
Primary practice location
204 S Nursery Rd
Ste 168
Irving, TX 75060-3184
Mailing address
204 S Nursery Rd
Ste 168
Irving, TX 75060-3184
Other names 1
- Dr. Sue Jin Choi
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7433 | TX | MD | Dentist |
| 2634 | OK | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vision Depot LLC | Optometrist | Current | Accepting new patients |
Locations
1515 N Cockrell Hill Rd
Ste 104
Dallas, TX 75211
Phone (214) 337-2020
Organizations & group practices 2
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": "1251158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480377600000",
"number": "1174756142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 S NURSERY RD",
"address_2": "STE 168",
"city": "IRVING",
"state": "TX",
"postal_code": "750603184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 S NURSERY RD",
"address_2": "STE 168",
"city": "IRVING",
"state": "TX",
"postal_code": "750603184",
"telephone_number": "972-579-4646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHONG",
"first_name": "SUE",
"middle_name": "JIN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-25",
"last_updated": "2016-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "7433",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OK",
"license": "2634",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUE",
"last_name": "CHOI",
"middle_name": "JIN",
"prefix": "DR.",
"credential": "O.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.