NPIMap

Organization Active NPI

Eyemart Express LLC

  • Eyewear Supplier
  • Odessa, TX
National Provider Identifier
1376941336
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
EYEMART EXPRESS LLC
Practice address
3869 E 42ND St
Odessa, TX 79762-5947
Phone
(432) 552-9191
Fax
(432) 363-2020
NPI assigned
Dec 8, 2014
Organization subpart
Yes
Parent organization
EYEMART EXPRESS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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

Authorized official

Name
Karen Pittman
Title
Director of Managed Care
Phone
(972) 788-2002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

3869 E 42ND St
Odessa, TX 79762-5947

Mailing address

3869 E 42ND St
Odessa, TX 79762-5947
Phone (432) 552-9191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150701000560 TX DME Supplier - Optician 7911228622 Practice locations: Odessa, TX

National Provider Directory

National Provider Directory
Tax ID family
Eyemart Express292 organizations share this tax ID, including this one
Part of
Eyemart Express

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1376941336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3869 E 42ND ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625947",
            "telephone_number": "432-552-9191",
            "fax_number": "432-363-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3869 E 42ND ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625947",
            "telephone_number": "432-552-9191",
            "fax_number": "432-363-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEMART EXPRESS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYEMART EXPRESS LLC",
        "enumeration_date": "2014-12-08",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "PITTMAN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE",
        "authorized_official_telephone_number": "972-788-2002"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; 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.