NPIMap

Organization Active NPI

Sam's East, Inc

Doing business as Sam's Vision Center 30-4911

  • Eyewear Supplier
  • Mansfield, TX
National Provider Identifier
1255767091
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
SAM'S EAST, INC
Doing business as
Sam's Vision Center 30-4911
Practice address
1740 North FM 157
Mansfield, TX 76063
Phone
(817) 779-6064
NPI assigned
Sep 25, 2013
Last updated
Sep 25, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
WAL-MART STORES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Authorized official

Name
Amy Powers
Title
Specialist, Plan Enrollment
Phone
(479) 204-0709

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU Primary
Optician 156FX1800X NU

Addresses

Primary practice location

1740 North FM 157
Mansfield, TX 76063

Mailing address

702 SW 8TH St
Bentonville, AR 72716-0445

Other names 1

  • Sam's Vision Center 30-4911 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sams Club Optical821 organizations share this tax ID, including this one
Part of
Walmart Pharmacy 10-206

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1380067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1255767091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 NORTH FM 157",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "76063",
            "telephone_number": "817-779-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM'S EAST, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAL-MART STORES, INC.",
        "enumeration_date": "2013-09-25",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "POWERS",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "SPECIALIST, PLAN ENROLLMENT",
        "authorized_official_telephone_number": "479-204-0709"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sam's Vision Center 30-4911",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.