Sebastian M Mirabal, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

5878TG Issued in TX

Practice address

1025 Long Prairie Rd
Suite 100
Flower Mound, TX 75022-4242

Phone

(972) 874-2407

Fax

(972) 874-2733

NPI assigned

Mar 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Optometry

Education

University of Houston - College of Optometry, 2000

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Sebastian Mirabal O.D., P.a.

  dba Lakeside Eye Care

  • Corneal and Contact Management Optometrist
  • Flower Mound, TX
  • NPI 1841327145
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248220800000",
    "number": "1285695148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 LONG PRAIRIE RD",
            "address_2": "SUITE 100",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750224242",
            "telephone_number": "972-874-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 LONG PRAIRIE RD",
            "address_2": "SUITE 100",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750224242",
            "telephone_number": "972-874-2407",
            "fax_number": "972-874-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRABAL",
        "first_name": "SEBASTIAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2009-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "5878TG",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5878TG",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deana Minchillo
• Mindmenders Clinic
• Jessica Susan Miner, M.S. CCC-SLP
• Mint Dentistry, PLLC (Flower Mound MINT Dentistry)
• Bryan H. Minton, M.D.
• Diana R Miranda, NP-C
• Nana Mireku, MD
• Arshia Mirhadi, D.C.
• Minaxi Mirkal, DDS
• Shyamala Miryala, MD

• Corneal and Contact Management Optometrist in Flower Mound, TX
• Providers in Flower Mound, TX by specialty
• Corneal and Contact Management Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.