Organization Active NPI

Dr. Laura Stancik, Optometrist, P. C.

  • Optometrist
  • Wichita Falls, TX
National Provider Identifier
1265564355
Registry record updated May 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5596T Issued in TX
Legal business name
DR. LAURA STANCIK, OPTOMETRIST, P. C.
Practice address
4210 Kell Blvd
Ste 108
Wichita Falls, TX 76309-4813
Phone
(940) 692-9696
Fax
(940) 692-7303
NPI assigned
Mar 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2013

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

Authorized official

Name
Ms. Becky Sue Clifton, ABOC
Title
Manager
Phone
(940) 692-9696

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 5596T TX Primary

Addresses

Primary practice location

4210 Kell Blvd
Ste 108
Wichita Falls, TX 76309-4813

Mailing address

4210 Kell Blvd
Ste 108
Wichita Falls, TX 76309-4813
Phone (940) 692-9696

Other names 1

  • Texas State Optical Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040415000717 TX Part B Supplier - Clinic/Group Practice 3971598418 Receives reassigned benefits from 3 practitioners
Practice locations: Wichita Falls, TX

National Provider Directory

National Provider Directory

Locations

4210 Kell Blvd
Ste 108
Wichita Falls, TX 76309
Phone (940) 692-9696

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367452800000",
    "number": "1265564355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4210 KELL BLVD",
            "address_2": "STE 108",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763094813",
            "telephone_number": "940-692-9696",
            "fax_number": "940-692-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 KELL BLVD",
            "address_2": "STE 108",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763094813",
            "telephone_number": "940-692-9696",
            "fax_number": "940-692-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. LAURA STANCIK, OPTOMETRIST, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2013-05-02",
        "status": "A",
        "authorized_official_last_name": "CLIFTON",
        "authorized_official_first_name": "BECKY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "940-692-9696",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ABOC"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5596T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas State Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.