Individual provider Active NPI

Larry D Tarrant, O.D.

  • Optometrist
  • Forney, TX
National Provider Identifier
1245264191
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5597TG Issued in TX
Practice address
104 E US Highway 80
Suite 100
Forney, TX 75126-8615
Phone
(972) 552-2020
Fax
(972) 552-1701
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5597TG TX Primary

Addresses

Primary practice location

104 E US Highway 80
Suite 100
Forney, TX 75126-8615

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other identifiers 1

IdentifierTypeStateIssuer
038435603MedicaidTX

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070430000285 TX Practitioner - Optometry 5395719223 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5597TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist CurrentSince Oct 5, 2020 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Oct 5, 2020 Accepting new patients
Med Southwest, PLLC Optometrist Current Accepting new patients
20/20 Icare and Iwear, PLLC Optometrist CurrentSince Mar 8, 2018 Accepting new patients

Locations

6446 Lyndon B Johnson Fwy
Dallas, TX 75240
Phone (972) 960-2020

1905 Abrams Rd
Dallas, TX 75214
Phone (214) 821-2020

104 E US Highway 80
Ste 100
Forney, TX 75126
Phone (972) 552-2020

4116 S Carrier Pkwy
Ste 120
Grand Prairie, TX 75052
Phone (972) 264-7200

2703 Richmond Rd
Texarkana, TX 75503
Phone (903) 838-0783

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: ltarrant018443@myeyedr.emadirect.md

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1245264191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "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": "104 E US HIGHWAY 80",
            "address_2": "SUITE 100",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751268615",
            "telephone_number": "972-552-2020",
            "fax_number": "972-552-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARRANT",
        "first_name": "LARRY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5597TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038435603",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forney, TX

Sources for this page

Verify at the official NPI Registry.