Patricia R Young, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5045TG Issued in TX

Practice address

807 Woodrow Wilson Ray Cir
Bridgeport, TX 76426-2062

Phone

(940) 683-2006

Fax

(940) 683-4411

NPI assigned

Oct 5, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Young'S Eye Center, P.a.

  • Optometrist
  • Bridgeport, TX
  • NPI 1780672568
  Medicare reassignment

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315267200000",
    "number": "1457348385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 WOODROW WILSON RAY CIR",
            "city": "BRIDGEPORT",
            "state": "TX",
            "postal_code": "764262062",
            "telephone_number": "940-683-2006",
            "fax_number": "940-683-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 WOODROW WILSON RAY CIR",
            "city": "BRIDGEPORT",
            "state": "TX",
            "postal_code": "764262062",
            "telephone_number": "940-683-2006",
            "fax_number": "940-683-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "PATRICIA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2011-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5045TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• West 380 Nursing Home Facility
• Angela S Whatley, CPHT
• Wise Clinical Care Associates
• Wise County Medical & Surgical Association
• Wise County Special Education Cooperative
• Young'S Eye Center, P.a.

• Optometrist in Bridgeport, TX
• Providers in Bridgeport, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.