Individual provider Active NPI

George E Orm III, OD

  • Optometrist
  • Dallas, TX
National Provider Identifier
1316982622
Registry record updated May 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2366T Issued in TX
Practice address
3636 McKinney Ave
Suite 120
Dallas, TX 75204-1422
Phone
(214) 252-1800
Fax
(214) 252-1801
NPI assigned
Jun 19, 2006
Last updated
May 28, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2366T TX Primary

Addresses

Primary practice location

3636 McKinney Ave
Suite 120
Dallas, TX 75204-1422

Mailing address

3636 McKinney Ave
Suite 120
Dallas, TX 75204-1422
Phone (214) 252-1800

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050406000242 TX Practitioner - Optometry 1153378757 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2366TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Texas Professional PLLC Optometrist CurrentSince Jan 2, 2021 Accepting new patients
George E. Orm, III, OD Optometrist Past Accepting new patients

Locations

3636 McKinney Ave
Ste 120
Dallas, TX 75204
Phone (214) 252-1800

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

6850 N Shiloh Rd
Ste T
Garland, TX 75044
Phone (972) 414-0444

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243468800000",
    "number": "1316982622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 MCKINNEY AVE",
            "address_2": "SUITE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041422",
            "telephone_number": "214-252-1800",
            "fax_number": "214-252-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 MCKINNEY AVE",
            "address_2": "SUITE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041422",
            "telephone_number": "214-252-1800",
            "fax_number": "214-252-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORM",
        "first_name": "GEORGE",
        "middle_name": "E",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2009-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2366T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.