Modern Optical

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

MODERN OPTICAL

Practice address

12802 Murphy Rd Ste C
Stafford, TX 77477-3902

Phone

(281) 494-3300

Fax

(281) 494-1585

NPI assigned

Mar 3, 2021

Organization subpart

No

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

Authorized official

Name

Rhoney Chacko

Title

Ceo

Phone

(281) 494-3300

Specialties & licenses 1

Addresses

Other names 1

• MODERN OPTICAL Former legal business name

Locations

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615248000000",
    "number": "1255926135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12802 MURPHY RD",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773902",
            "telephone_number": "281-494-3300",
            "fax_number": "281-494-1585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12802 MURPHY RD STE C",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773902",
            "telephone_number": "281-494-3300",
            "fax_number": "281-494-1585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A",
        "authorized_official_last_name": "CHACKO",
        "authorized_official_first_name": "RHONEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "281-494-3300"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MODERN OPTICAL",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Optician in Stafford, TX
• Providers in Stafford, TX by specialty
• Optician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.