Robert W Anderson Jr., OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2195TG Issued in TX

Practice address

2801 S John Redditt Dr
Lufkin, TX 75904

Phone

(936) 637-2020

Fax

(936) 634-4911

NPI assigned

Oct 18, 2005

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Angelina Optometric Associates

  • Optometrist
  • Lufkin, TX
  • NPI 1366453920
  NPD (past) Authorized official
• Eye Center of Jasper, PLLC

  • Optometrist
  • Jasper, TX
  • NPI 1659851277
  NPD (past)

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1306835715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 S JOHN REDDITT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "75904",
            "telephone_number": "936-637-2020",
            "fax_number": "936-634-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 S JOHN REDDITT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "75904",
            "telephone_number": "936-637-2020",
            "fax_number": "936-634-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2195TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "75-2127920",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045118901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "86G681",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tina Michele Alvey, DC
• Eduardo Amadio Anzaloni
• Amedisys Texas LLC (Amedisys Home Health)
• Americare EMS LLC (Americare)
• Penelope Anderson
• Jacky Andreatta, M.AT, LAT, ATC
• Andrew J. Fercowicz, M.D.,P.a.
• Angel's Choice Home Health Professionals, LLC
• Angelina Alliance for Children
• Angelina County & Cities Health District

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.