Active NPI
Rebecca Adricula
- Optician
- Tyler, TX
National Provider Identifier
1467282152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- SLD43256
- Practice address
- 450 S Southeast Loop 323
Tyler, TX 75702-8646 - Phone
- (903) 405-6387
- Fax
- (903) 526-0498
- NPI assigned
- Aug 6, 2024
- Last updated
- Aug 6, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 253738 | CA | |
| Optician | 156FX1800X | SLD43256 | CA | Primary |
Addresses
Primary practice location
450 S Southeast Loop 323
Tyler, TX 75702-8646
Mailing address
450 S Southeast Loop 323
Tyler, TX 75702-8646
Phone (903) 405-6387
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 253738 | CA | MD | Optician |
| SLD43256 | CA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"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": []
}Other providers in Tyler, TX
Sources for this page
- 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.