NPIMap

Organization Active NPI

Columbus Optical Company, LTD.

  • Durable Medical Equipment & Medical Supplies
  • La Grange, TX
National Provider Identifier
1386601631
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
COLUMBUS OPTICAL COMPANY, LTD.
Practice address
108 N Washington St
La Grange, TX 78945-2627
Phone
(979) 968-3953
Fax
(979) 968-3435
NPI assigned
Apr 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Authorized official

Name
Bob D. Moore
Title
Administrator
Phone
(979) 732-5771

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

108 N Washington St
La Grange, TX 78945-2627

Mailing address

100 Sweetbriar Dr
Columbus, TX 78934-3008
Phone (979) 732-5771

Other identifiers 1

IdentifierTypeStateIssuer
141463305MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930040890 TX DME Supplier - Physician - OptometristDME Supplier - Optician 7214048735 Practice locations: La Grange, TX

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Columbus Optical Company LTD4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the 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": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1386601631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SWEETBRIAR DR",
            "city": "COLUMBUS",
            "state": "TX",
            "postal_code": "789343008",
            "telephone_number": "979-732-5771",
            "fax_number": "979-732-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N WASHINGTON ST",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "789452627",
            "telephone_number": "979-968-3953",
            "fax_number": "979-968-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBUS OPTICAL COMPANY, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "BOB",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "979-732-5771"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141463305",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.