Organization Active NPI

New Braunfels Texas State Optical, PLLC.

  • Optometrist
  • New Braunfels, TX
National Provider Identifier
1316464886
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8234 Issued in TX
Legal business name
NEW BRAUNFELS TEXAS STATE OPTICAL, PLLC.
Practice address
1705 S Walnut Ave Ste 100
New Braunfels, TX 78130-1116
Phone
(830) 629-1248
NPI assigned
Aug 25, 2017
Last updated
Jul 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Authorized official

Name
Dr. Jeslyn Sabol, ODNPI 1609216282
Title
Optometrist
Phone
(512) 658-3079

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 8234 TX Primary

Addresses

Primary practice location

1705 S Walnut Ave Ste 100
New Braunfels, TX 78130-1116

Mailing address

2406 Hunter Rd Ste 102
San Marcos, TX 78666-5256

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180227002458 TX Part B Supplier - Clinic/Group Practice 0345501730 Receives reassigned benefits from 3 practitioners
Practice locations: New Braunfels, TX

National Provider Directory

National Provider Directory

Locations

101A Interstate 35 S
New Braunfels, TX 78130

1705 S Walnut Ave
Ste 100
New Braunfels, TX 78130
Phone (830) 629-1248

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1316464886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 HUNTER RD STE 102",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786665256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 S WALNUT AVE STE 100",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781301116",
            "telephone_number": "830-629-1248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW BRAUNFELS TEXAS STATE OPTICAL, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-25",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "SABOL",
        "authorized_official_first_name": "JESLYN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "512-658-3079",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Braunfels, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; 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.