Stephenville Optical, PA

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

STEPHENVILLE OPTICAL, PA

Doing business as

TEXAS STATE OPTICAL

Practice address

101 N Dale Ave
Stephenville, TX 76401-2832

Phone

(254) 968-4133

Fax

(254) 968-5631

NPI assigned

Apr 4, 2007

Organization subpart

No

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

Authorized official

Name

Dey Rodriguez

Title

Office Manager

Phone

(254) 968-4133

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• TEXAS STATE OPTICAL Doing business as

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496966400000",
    "number": "1275655730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N DALE AVE",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764012832",
            "telephone_number": "254-968-4133",
            "fax_number": "254-968-5631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N DALE AVE",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764012832",
            "telephone_number": "254-968-4133",
            "fax_number": "254-968-5631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHENVILLE OPTICAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2017-06-09",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "DEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "254-968-4133"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1123911-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TEXAS STATE OPTICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Eyewear Supplier in Stephenville, TX
• Providers in Stephenville, TX by specialty
• Eyewear Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2017; 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.