Individual provider Active NPI

Alberto Camacho Quevedo, OD

  • Optometrist
  • Lubbock, TX
National Provider Identifier
1346761889
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9181 Issued in TX
Practice address
6010 82ND St Ste 200
Lubbock, TX 79424-0822
Phone
(806) 798-8820
Fax
(806) 798-9754
NPI assigned
Jul 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9181 TX Primary

Addresses

Primary practice location

6010 82ND St Ste 200
Lubbock, TX 79424-0822

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

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
I20170728000779 TX Practitioner - Optometry 3173893849 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med Southwest PLLCGroup PAC ID 4082952874, 234 clinicians

Practice addresses (Care Compare)

3104 Indiana Ave
Lubbock, TX 79410-3148
Phone (806) 793-1927

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9181TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist CurrentSince Jul 25, 2022 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Jul 25, 2022 Accepting new patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Silver Spring Optometry, LLC Optometrist Past Accepting new patients

Locations

3104 Indiana Ave
Lubbock, TX 79410
Phone (803) 793-1927

6010 82nd St
Ste 200
Lubbock, TX 79424
Phone (806) 798-8820

2703 Richmond Rd
Texarkana, TX 75503
Phone (903) 838-0783

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1346761889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6010 82ND ST STE 200",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794240822",
            "telephone_number": "806-798-8820",
            "fax_number": "806-798-9754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMACHO QUEVEDO",
        "first_name": "ALBERTO",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-06",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.