Individual provider Active NPI

Jacklyn Alaquinez, O.D.

  • Optometrist
  • Floresville, TX
National Provider Identifier
1417335175
Registry record updated Jan 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8641TG Issued in TX
Practice address
301 10TH St Ste 3
Floresville, TX 78114-3197
Phone
(830) 393-7744
Fax
(830) 393-7703
NPI assigned
May 14, 2015
Last updated
Jan 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8641TG TX Primary

Addresses

Primary practice location

301 10TH St Ste 3
Floresville, TX 78114-3197

Mailing address

205B W Water St
Kerrville, TX 78028-4252
Phone (830) 896-2600

Other identifiers 1

IdentifierTypeStateIssuer
351700501MedicaidTX

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
I20150709002795 TX Practitioner - Optometry 5395057939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

301 10TH St
Suite 3
Floresville, TX 78114-3197
Phone (830) 393-7744

3551 Justin Rd
Suite 150
Flower Mound, TX 75028-6213
Phone (972) 355-5152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8641TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Texas Professional PLLC Optometrist CurrentSince Sep 21, 2019 Accepting new patients
Dianne Bui Dao OD PC Optometrist PastSince Apr 24, 2011 Accepting new patients
Pope Enterprises PLLC Optometrist Past Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients

Locations

3908 Far West Blvd
Austin, TX 78731
Phone (512) 343-0432

12320 Barker Cypress Rd
Ste 400
Cypress, TX 77429
Phone (281) 373-1020

301 10th St
Ste 3
Floresville, TX 78114
Phone (830) 393-7744

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

508 S Adams St
Fredericksburg, TX 78624
Phone (830) 997-2504

1102 S Friendswood Dr
Ste A
Friendswood, TX 77546
Phone (281) 482-0066

6850 N Shiloh Rd
Ste T
Garland, TX 75044
Phone (972) 414-0444

1620 Avenue M
Hondo, TX 78861
Phone (830) 741-2634

1620 Avenue M
#C
Hondo, TX 78861
Phone (830) 741-2634

205B W Water St
Kerrville, TX 78028
Phone (830) 896-2600

2705 Broadway St
Ste 115
Pearland, TX 77581
Phone (281) 485-2020

1205 N Loop 1604 W
San Antonio, TX 78258
Phone (210) 319-2900

15677 San Pedro Ave
Ste B
San Antonio, TX 78232
Phone (210) 366-1199

1650 Culebra Rd
San Antonio, TX 78201

5230 De Zavala Rd
San Antonio, TX 78249
Phone (210) 694-0500

670 E Southlake Blvd
Southlake, TX 76092
Phone (817) 329-6466

20630 State Highway 46 W
Ste 120
Spring Branch, TX 78070
Phone (830) 980-3306

5011 Walzem Rd
Windcrest, TX 78218
Phone (210) 646-6194

Organizations & group practices 4

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": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1417335175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205B W WATER ST",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780284252",
            "telephone_number": "830-896-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 10TH ST STE 3",
            "city": "FLORESVILLE",
            "state": "TX",
            "postal_code": "781143197",
            "telephone_number": "830-393-7744",
            "fax_number": "830-393-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAQUINEZ",
        "first_name": "JACKLYN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-14",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8641TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "351700501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Floresville, TX

Sources for this page

Verify at the official NPI Registry.