Individual provider Active NPI

Obed Eduardo Perez de la Pena, O.D

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1356003966
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6011 Issued in FL
Practice address
4631 S Hulen St
Fort Worth, TX 76132-1401
Phone
(817) 346-7077
Fax
(817) 346-6998
NPI assigned
Oct 11, 2021
Last updated
Apr 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC6011 FL Primary

Addresses

Primary practice location

4631 S Hulen St
Fort Worth, TX 76132-1401

Mailing address

4631 S Hulen St
Fort Worth, TX 76132-1401
Phone (817) 346-7077

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address opena@araneye.com Direct Aran Eye Associates PA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230131000618 TN Practitioner - Optometry 8921492414 Reassigns benefits to 1 organization
I20250102000335 TX Practitioner - Optometry 8921492414 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyeworks at West 7THGroup PAC ID 6002206042, 4 clinicians
The Eye Group of Texas, LLCGroup PAC ID 7012096928, 5 clinicians
DRCS Group, Inc.Group PAC ID 4880871516, 6 clinicians

Practice addresses (Care Compare)

3017 W 7TH St
Suite 210
Fort Worth, TX 76107-2223
Phone (817) 348-9090

3105 E Southlake Boulevard
Southlake, TX 76092-8051
Phone (817) 310-3989

4631 S Hulen St
Fort Worth, TX 76132-1401
Phone (817) 346-7077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3785TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Antioch Eye Care Center, Physician & Surgeon, PLLC Optometrist CurrentSince Dec 1, 2022 Accepting new patients
The Eye Group of Texas LLC Optometrist CurrentSince Jan 20, 2025 Accepting new patients
Eyeworks at West 7TH Optometrist CurrentSince Jan 20, 2025 Accepting new patients
DRCS Group, Inc. Optometrist CurrentSince Jan 20, 2025 Accepting new patients
Stanley D Braverman MD LLC Optometrist PastSince Oct 1, 2021 Accepting new patients
7TH Street Eyeworks, Inc. Optometrist Past Accepting new patients

Locations

554 Bell Rd
Antioch, TN 37013
Phone (615) 361-7266

500 Burkitt Commons Ave
Nolensville, TN 37135
Phone (615) 709-2700

3017 W 7th St
Ste 210
Fort Worth, TX 76107
Phone (817) 346-7077

4631 S Hulen St
Ft Worth, TX 76132
Phone (817) 346-7077

3105 E Southlake Blvd
Southlake, TX 76092
Phone (817) 310-3989

Organizations & group practices 6

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": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1356003966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4631 S HULEN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761321401",
            "telephone_number": "817-346-7077",
            "fax_number": "817-346-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4631 S HULEN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761321401",
            "telephone_number": "817-346-7077",
            "fax_number": "817-346-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ DE LA PENA",
        "first_name": "OBED",
        "middle_name": "EDUARDO",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-11",
        "last_updated": "2025-04-24",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "opena@araneye.com",
            "affiliation": "Y",
            "endpointDescription": "opena@araneye.com",
            "affiliationName": "Aran Eye Associates PA",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1097 S Le Jeune Rd",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331342639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.