NPIMap

Organization Active NPI

Todd R. Brantley, LLC

Doing business as Lone Star Vision

  • Optometrist
  • Celina, TX
National Provider Identifier
1215278510
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5711TG Issued in TX
Legal business name
TODD R. BRANTLEY, LLC
Doing business as
Lone Star Vision
Practice address
1060 S Preston Rd
#100
Celina, TX 75009-3894
Phone
(972) 382-2020
Fax
(972) 378-9094
NPI assigned
Mar 12, 2013
Last updated
Apr 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shardee Seraile, CPOC
Title
Insurance Manager
Phone
(972) 378-4104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5711TG TX Primary

Addresses

Primary practice location

1060 S Preston Rd
#100
Celina, TX 75009-3894

Mailing address

1060 S Preston Rd
#100
Celina, TX 75009-3894
Phone (972) 382-2020

Other names 1

  • Lone Star Vision Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130506000070 TX Part B Supplier - Clinic/Group Practice 7416194725 Receives reassigned benefits from 6 practitioners
Practice locations: Celina, TX

National Provider Directory

National Provider Directory

Locations

1060 S Preston Rd
Ste 100
Celina, TX 75009
Phone (972) 382-2020

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1363046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364947200000",
    "number": "1215278510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 S PRESTON RD",
            "address_2": "#100",
            "city": "CELINA",
            "state": "TX",
            "postal_code": "750093894",
            "telephone_number": "972-382-2020",
            "fax_number": "972-378-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 S PRESTON RD",
            "address_2": "#100",
            "city": "CELINA",
            "state": "TX",
            "postal_code": "750093894",
            "telephone_number": "972-382-2020",
            "fax_number": "972-378-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TODD R. BRANTLEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-12",
        "last_updated": "2013-04-03",
        "status": "A",
        "authorized_official_last_name": "SERAILE",
        "authorized_official_first_name": "SHARDEE",
        "authorized_official_title_or_position": "INSURANCE MANAGER",
        "authorized_official_telephone_number": "972-378-4104",
        "authorized_official_credential": "CPOC"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5711TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lone Star Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Celina, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.