Carl Hubert Malone Jr.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4293T Issued in TX

Practice address

4540 Sherwood Way
Suite 104a
San Angelo, TX 76901-5619

Phone

(325) 947-1505

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 1990

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344384000000",
    "number": "1417047515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60251",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769060251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 SHERWOOD WAY",
            "address_2": "SUITE 104A",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769015619",
            "telephone_number": "325-947-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "CARL",
        "middle_name": "HUBERT",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2012-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4293T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093500902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick Leroy Mahan, D. C.
• Patrick Clarence Makins, DDS MSD
• Peggy Lee Makowski, C.O.T.A.
• Colleen Mallory
• Malone House
• Stacey L Manion, DO
• Robert Charles Mankin, D.D.S.
• Destiny Renee Manley
• Patricia T Manning, CRNA
• Liem Thanh Mansfield, MD

• Optometrist in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.