Individual provider Active NPI

Lisa Carol Bowen, O.D.

  • Optometrist
  • Flower Mound, TX
National Provider Identifier
1457365173
Registry record updated Apr 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5378TG Issued in TX
Practice address
2570 Northshore Blvd
Suite 200
Flower Mound, TX 75028-4217
Phone
(972) 539-3900
Fax
(972) 539-7333
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5378TG TX Primary

Addresses

Primary practice location

2570 Northshore Blvd
Suite 200
Flower Mound, TX 75028-4217

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

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
I20050122000037 TX Practitioner - Optometry 9739138223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med Southwest PLLCGroup PAC ID 4082952874, 234 clinicians

Practice addresses (Care Compare)

2570 Northshore Blvd
Suite 200
Flower Mound, TX 75028-8386
Phone (972) 539-3900

2703 Richmond Rd
Texarkana, TX 75503-2328
Phone (903) 838-0783

3032 N Eastman Rd
Suite 100
Longview, TX 75605-5024
Phone (903) 663-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5378TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist CurrentSince May 31, 2022 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince May 31, 2022 Accepting new patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Silver Spring Optometry, LLC Optometrist Past Accepting new patients

Locations

2570 Northshore Blvd
Ste 200
Flower Mound, TX 75028
Phone (972) 539-3900

3032 N Eastman Rd
Ste 100
Longview, TX 75605
Phone (903) 663-2020

1247 Main St
Southlake, TX 76092
Phone (817) 481-2070

2703 Richmond Rd
Texarkana, TX 75503
Phone (903) 838-0783

8329 Whitley Rd
Watauga, TX 76148
Phone (817) 431-2020

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650672000000",
    "number": "1457365173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 NORTHSHORE BLVD",
            "address_2": "SUITE 200",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750284217",
            "telephone_number": "972-539-3900",
            "fax_number": "972-539-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "LISA",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2022-04-23",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5378TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

Verify at the official NPI Registry.