Texarkana Eye Associates

Primary specialty

OptometristTaxonomy code 152W00000X

License

5241T Issued in TX

Legal business name

TEXARKANA EYE ASSOCIATES

Practice address

2703 Richmond Rd
Texarkana, TX 75503-2328

Phone

(903) 838-0783

Fax

(903) 831-6145

NPI assigned

Nov 16, 2006

Last updated

Sep 30, 2011By 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

Dr. Elvin W Fenton, OD

Title

Doctor

Phone

(903) 838-0783

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317340800000",
    "number": "1205909272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 RICHMOND RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032328",
            "telephone_number": "903-838-0783",
            "fax_number": "903-831-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 RICHMOND RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032328",
            "telephone_number": "903-838-0783",
            "fax_number": "903-831-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXARKANA EYE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2011-09-30",
        "status": "A",
        "authorized_official_last_name": "FENTON",
        "authorized_official_first_name": "ELVIN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "903-838-0783",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5241T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "00E39Y",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134244722",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019333601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BCBS",
            "identifier": "8P157",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Texarkana Elder Services, Inc. Dba Edgewood Manor Nursing Home
• Texarkana Emergency Center, LLC (SignatureCare Emergency Centers, LLC)
• Texarkana Emergency Medicine Physicians,PA
• Texarkana Emergency Physicians PLLC
• Texarkana ER, LLC (Texarkana Emergency Center & Hospital)
• Texarkana Eye Associates
• Texarkana Eye Care Center LLP (Vision Source of Texarkana)
• Texarkana Family Practice, P.a.
• Texarkana Gastroenterology Consultants, PA
• Texarkana Health & Wellness, LLC (United Health and Wellness)

• Optometrist in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.