Texas Eye Clinic PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

5741TG Issued in TX

Legal business name

TEXAS EYE CLINIC PC

Practice address

3575 W Walnut St
C
Garland, TX 75042-6208

Phone

(972) 272-9455

Fax

(972) 665-0360

NPI assigned

Feb 28, 2007

Last updated

May 3, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kimberly Nguyen, O.D.NPI 1386790244

Title

Director

Phone

(972) 272-9455

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen Khong, OD

  • Optometrist
  • Garland, TX
  • NPI 1437274065
  Medicare reassignment
• Kimberly Nguyen, O.D.

  • Optometrist
  • Garland, TX
  • NPI 1386790244
  Authorized official Same address or phone
• Kennedy Noel Khong, OD

  • Optometrist
  • Garland, TX
  • NPI 1235852740
  NPD

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336003200000",
    "number": "1386771855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 W WALNUT ST",
            "address_2": "C",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750426208",
            "telephone_number": "972-272-9455",
            "fax_number": "972-665-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 W WALNUT ST",
            "address_2": "C",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750426208",
            "telephone_number": "972-272-9455",
            "fax_number": "972-665-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS EYE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2012-05-03",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "972-272-9455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5573T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5741TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019087801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "11585",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "TX5741",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Garland, TX
• Providers in Garland, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; 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.