Eric Alan Packwood, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

L0479 Issued in TX

Practice address

321 S Henderson St
Fort Worth, TX 76104-1016

Phone

(817) 529-9949

Fax

(817) 529-9943

NPI assigned

Feb 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 10

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Ophthalmology

Education

Baylor College of Medicine, 1991

Medicare assignment

May accept Medicare assignment

Group practices

Pediatric Eye Specialists LLPGroup PAC ID 8022082437, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/
• Direct secure messaging: epackwood75984@unitedregional.medalliesdirect.net
• FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Pediatric Eye Specialists LLP

  • Ophthalmology Physician
  • Fort Worth, TX
  • NPI 1760507149
  Medicare reassignment Care Compare group NPD
• Specialeyes Optical, LLC

  • Optometrist
  • Keller, TX
  • NPI 1679028542
  NPD (past) Authorized official
• United Regional Health Care System Inc

  • General Acute Care Hospital
  • Wichita Falls, TX
  • NPI 1023013448
  NPD
• Specialeyes Optical, LLC

  • Optometrist
  • Denton, TX
  • NPI 1821564964
  NPD (past)

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291766400000",
    "number": "1366414773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 S HENDERSON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761041016",
            "telephone_number": "817-529-9949",
            "fax_number": "817-529-9943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 S HENDERSON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761041016",
            "telephone_number": "817-529-9949",
            "fax_number": "817-529-9943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKWOOD",
        "first_name": "ERIC",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2010-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "L0479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018440004",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152778001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS FIRST CARE 12940",
            "identifier": "120897101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "018440004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CARE STAR MEDICAID",
            "identifier": "139925100",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7931102",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA OPTICARE",
            "identifier": "H41514",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8G6221",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8G6220",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00075436",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pack Optical
• Andrew Pack, MD
• Christopher Shawn Pack, D.D.S.
• Leonard R. Pack, O.D.
• Whitney Childs Pack, CPNP-AC
• Sydney Padget, OTR
• Alyssa Padilla
• Audrey Padilla
• Gabriela Ana Padilla, LPC
• Melissa Padilla, LMSW

• Ophthalmology Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.