Active NPI
Jerry L Elliott, O.D.
- Optometrist
- Garland, TX
National Provider Identifier
1417020884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2081T
- Practice address
- 3159 S Garland Ave
511B
Garland, TX 75041-4000 - Phone
- (972) 840-1776
- Fax
- (972) 840-1886
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2081T | TX | Primary |
Addresses
Primary practice location
3159 S Garland Ave
511B
Garland, TX 75041-4000
Mailing address
10442 Lippitt Ave
Dallas, TX 75218-2251
Phone (972) 840-1776
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2081T | TX | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788048000000",
"number": "1417020884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10442 LIPPITT AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752182251",
"telephone_number": "972-840-1776",
"fax_number": "972-840-1886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3159 S GARLAND AVE",
"address_2": "511B",
"city": "GARLAND",
"state": "TX",
"postal_code": "750414000",
"telephone_number": "972-840-1776",
"fax_number": "972-840-1886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "JERRY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2026-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "2081T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Garland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.