Donald B Bogue, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3013TG Issued in TX

Practice address

2801 S John Redditt Dr
Lufkin, TX 75904-5666

Phone

(936) 637-2020

Fax

(936) 634-4911

NPI assigned

Oct 17, 2005

Last updated

May 20, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Eye Center of Jasper, PLLC

  • Optometrist
  • Jasper, TX
  • NPI 1659851277
  NPD (past)

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1467441071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 S JOHN REDDITT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759045666",
            "telephone_number": "936-637-2020",
            "fax_number": "936-634-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 S JOHN REDDITT DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759045666",
            "telephone_number": "936-637-2020",
            "fax_number": "936-634-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGUE",
        "first_name": "DONALD",
        "middle_name": "B",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3013TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112479402",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "75-2127920",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "86G682",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blaine Randall Blakestad, MD
• Maria Magdalena Blalock, FNP
• Bonnie Lynn Bodenstedt, OTR/L
• Ivonne Boeta, MD
• Audrey Katherine Bogue, RD
• Kaydi Joa Boles, SLP
• Reagan Darice Novak Bonin, M.D.
• Crystal Little Bonner, LPC
• John Byron Boone
• Robin Denise Borel, OT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.