Active NPI
Bronaugh Independent Opticians Inc.
- Durable Medical Equipment & Medical Supplies
- Lufkin, TX
National Provider Identifier
1184881732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- BRONAUGH INDEPENDENT OPTICIANS INC.
- Practice address
- 109 Gaslight Blvd
Lufkin, TX 75904-3167 - Phone
- (936) 632-1010
- Fax
- (936) 632-3233
- NPI assigned
- May 21, 2008
- 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
- Charda P Bronaugh
- Title
- Corporate President
- Phone
- (936) 632-1010
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
109 Gaslight Blvd
Lufkin, TX 75904-3167
Mailing address
109 Gaslight Blvd
Lufkin, TX 75904-3167
Phone (936) 632-1010
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80112 | Other | AZ | AVESIS |
| 925101 | Other | TX | BLOCK VISION OF TEXAS |
| 0906860002 | Other | TX | TRS ACTIVCARE |
| 908788 | Other | TX | BLOCK VISION OF TEXAS INC |
| 086517201 | Medicaid | TX | |
| 5090961 | Other | CT | CONNECTICUT GENERAL LIFE INSURANCE CO |
| 0906860002 | Other | SC | TRICARE HUMANA MILITARY HEALTHCARE SERVICES |
| 0906860002 | Other | CA | SUPERIOR VISION SERVICES INC |
| 4007229 | Other | TN | BLUE CROSS BLUE SHIELD OF TENNESSEE |
| 504262 | Other | TX | BLUE CROSS BLUE SHIELD OF TEXAS |
| OP1740 | Other | OH | EYEMED VISION CARE |
| 32603 | Other | TX | OPTICARE MANAGED VISION |
| 0906860002 | Other | NE | AMERITAS LIFE INSURANCE CORP |
| 0005524399 | Other | KY | AETNA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211328000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1211328000000",
"number": "1184881732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 GASLIGHT BLVD",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043167",
"telephone_number": "936-632-1010",
"fax_number": "936-632-3233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 GASLIGHT BLVD",
"city": "LUFKIN",
"state": "TX",
"postal_code": "759043167",
"telephone_number": "936-632-1010",
"fax_number": "936-632-3233"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRONAUGH INDEPENDENT OPTICIANS INC.",
"organizational_subpart": "NO",
"enumeration_date": "2008-05-21",
"last_updated": "2008-05-21",
"status": "A",
"authorized_official_last_name": "BRONAUGH",
"authorized_official_first_name": "CHARDA",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "CORPORATE PRESIDENT",
"authorized_official_telephone_number": "936-632-1010"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVESIS",
"identifier": "80112",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLOCK VISION OF TEXAS",
"identifier": "925101",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRS ACTIVCARE",
"identifier": "0906860002",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLOCK VISION OF TEXAS INC",
"identifier": "908788",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "086517201",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICUT GENERAL LIFE INSURANCE CO",
"identifier": "5090961",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE HUMANA MILITARY HEALTHCARE SERVICES",
"identifier": "0906860002",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUPERIOR VISION SERVICES INC",
"identifier": "0906860002",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF TENNESSEE",
"identifier": "4007229",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF TEXAS",
"identifier": "504262",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYEMED VISION CARE",
"identifier": "OP1740",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTICARE MANAGED VISION",
"identifier": "32603",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERITAS LIFE INSURANCE CORP",
"identifier": "0906860002",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0005524399",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lufkin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.