Organization Active NPI

Eyes on Dallas PLLC

Doing business as Eyes On Dallas

  • Optometrist
  • Dallas, TX
National Provider Identifier
1336807940
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYES ON DALLAS PLLC
Doing business as
Eyes On Dallas
Practice address
12835 Preston Rd Ste 218
Dallas, TX 75230-1277
Phone
(214) 890-9864
NPI assigned
Dec 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Authorized official

Name
Dr. Mai Nguyen, ODNPI 1356699276
Title
Optometrist
Phone
(214) 890-9864

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 Primary

Addresses

Primary practice location

12835 Preston Rd Ste 218
Dallas, TX 75230-1277

Mailing address

17752 Agave LN
Dallas, TX 75252-8041
Phone (972) 768-3338

Other names 1

  • Eyes On Dallas Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220302001617 TX Part B Supplier - Clinic/Group Practice 6406240761 Receives reassigned benefits from 1 practitioner
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638316800000",
    "number": "1336807940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17752 AGAVE LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752528041",
            "telephone_number": "972-768-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12835 PRESTON RD STE 218",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752301277",
            "telephone_number": "214-890-9864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYES ON DALLAS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "MAI",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "214-890-9864",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyes On Dallas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.