Individual provider Active NPI

Charles Alexander Knowles, O.D.

  • Corneal and Contact Management Optometrist
  • Fort Worth, TX
National Provider Identifier
1407985880
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
3132T Issued in TX
Practice address
309 S Oakland Blvd
Fort Worth, TX 76103-3762
Phone
(817) 536-9970
Fax
(817) 531-2534
NPI assigned
Mar 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 3132T TX Primary

Addresses

Primary practice location

309 S Oakland Blvd
Fort Worth, TX 76103-3762

Mailing address

309 S Oakland Blvd
Fort Worth, TX 76103-3762
Phone (817) 536-9970

Other names 1

  • Dr. Calex Knowles Professional name

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
I20201218000684 TX Practitioner - Optometry 9931511755 Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3132TTXMDCorneal and Contact Management Optometrist

NPI Registry JSON

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1407985880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 S OAKLAND BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761033762",
            "telephone_number": "817-536-9970",
            "fax_number": "817-531-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 S OAKLAND BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761033762",
            "telephone_number": "817-536-9970",
            "fax_number": "817-531-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOWLES",
        "first_name": "CHARLES",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-03",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "3132T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CALEX",
            "last_name": "KNOWLES",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.