Active NPI
Med Southwest, PLLC
Doing business as MyEyeDr.
- Optometrist
- Fort Worth, TX
National Provider Identifier
1215744552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- MED SOUTHWEST, PLLC
- Doing business as
- MyEyeDr.
- Practice address
- 5421 Basswood Blvd Ste 740
Fort Worth, TX 76137-4483 - Phone
- (817) 428-2020
- Fax
- (817) 656-1900
- NPI assigned
- Dec 11, 2024
- Last updated
- Dec 11, 2024
- 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
- Sue Downes
- Title
- Secretary
- Phone
- (703) 847-8899
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
5421 Basswood Blvd Ste 740
Fort Worth, TX 76137-4483
Mailing address
8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899
Other names 1
- MyEyeDr.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190221001481 | TX | Part B Supplier - Clinic/Group Practice | 4082952874 |
Receives reassigned benefits from 379 practitioners This NPI is an additional NPI on the enrollment |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2155774 | Med Southwest, PLLC | Certificate of waiver | Oct 3, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Med Southwest PLLC
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733875200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1733875200000",
"number": "1215744552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8614 WESTWOOD CENTER DR FL 9",
"city": "VIENNA",
"state": "VA",
"postal_code": "221822442",
"telephone_number": "703-847-8899",
"fax_number": "571-223-6780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5421 BASSWOOD BLVD STE 740",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761374483",
"telephone_number": "817-428-2020",
"fax_number": "817-656-1900"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MED SOUTHWEST, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-12-11",
"last_updated": "2024-12-11",
"certification_date": "2024-12-11",
"status": "A",
"authorized_official_last_name": "DOWNES",
"authorized_official_first_name": "SUE",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "703-847-8899"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "MyEyeDr.",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.