Individual provider Active NPI

Landon Lance Liska, OD

  • Optometrist
  • McAllen, TX
National Provider Identifier
1396745998
Registry record updated May 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6227TG Issued in TX
Practice address
5801 N 10TH St
Ste #200
McAllen, TX 78504-2610
Phone
(956) 992-9100
Fax
(956) 992-0410
NPI assigned
Jul 26, 2005
Last updated
May 16, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6227TG TX Primary

Addresses

Primary practice location

5801 N 10TH St
Ste #200
McAllen, TX 78504-2610

Mailing address

5801 N 10TH St
Ste #200
McAllen, TX 78504-2610
Phone (956) 992-9100

Other identifiers 1

IdentifierTypeStateIssuer
171477601MedicaidTX

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040611001295 TX Practitioner - Optometry 4587647243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5801 N 10TH St
Suite 200
McAllen, TX 78504-2601
Phone (956) 992-9100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6227TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Landon L. Liska Enterprises, P.C. Optometrist CurrentSince Dec 1, 2010 Accepting new patients
I.O.U. Enterprises Inc Optometrist PastSince Apr 30, 1997 Accepting new patients
William Justus Head MD PA Past Accepting new patients

Locations

5801 N 10th St
Ste 200
McAllen, TX 78504
Phone (956) 624-6294

Organizations & group practices 3

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": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305504000000",
    "number": "1396745998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 N 10TH ST",
            "address_2": "STE #200",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785042610",
            "telephone_number": "956-992-9100",
            "fax_number": "956-992-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 N 10TH ST",
            "address_2": "STE #200",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785042610",
            "telephone_number": "956-992-9100",
            "fax_number": "956-992-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISKA",
        "first_name": "LANDON",
        "middle_name": "LANCE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2011-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6227TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171477601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

Verify at the official NPI Registry.