Omar Gonzalez, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

7234T Issued in TX

Practice address

3814 W Illinois Ave
Dallas, TX 75211-8500

Phone

(214) 331-4700

Fax

(214) 331-4712

NPI assigned

Jul 10, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Today'S Vision Oak Cliff PLLC

  • Optometrist
  • Dallas, TX
  • NPI 1407181043
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1275796179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3814 W ILLINOIS AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752118500",
            "telephone_number": "214-331-4700",
            "fax_number": "214-331-4712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3814 W ILLINOIS AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752118500",
            "telephone_number": "214-331-4700",
            "fax_number": "214-331-4712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "OMAR",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7234T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210710401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marlen Gonzalez, MSN, RN, CPNP-AC
• Marta M Gonzalez, OTR
• Monica Gonzalez, MD
• Nancy Gonzalez, MD
• Nelson Eduardo Gonzalez, DPT
• Pablo Gonzalez, RPH
• Roberto Gonzalez
• Roberto Gonzalez, MS, RD, LD, CDE
• Ruben David Gonzalez, M.D.
• Sandra M Gonzalez

• Optometrist in Dallas, TX
• Providers in Dallas, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.