Rebecca Adricula

Primary specialty

OpticianTaxonomy code 156FX1800X

License

SLD43256 Issued in CA

Practice address

450 S Southeast Loop 323
Tyler, TX 75702-8646

Phone

(903) 405-6387

Fax

(903) 526-0498

NPI assigned

Aug 6, 2024

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 6, 2024.

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1467282152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 S SOUTHEAST LOOP 323",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028646",
            "telephone_number": "903-405-6387",
            "fax_number": "903-526-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S SOUTHEAST LOOP 323",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028646",
            "telephone_number": "903-405-6387",
            "fax_number": "903-526-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADRICULA",
        "first_name": "REBECCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "253738",
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "CA",
            "license": "SLD43256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Tyler, TX
• Optician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.