NPIMap

Organization Active NPI

Texas Retina Associates

  • Ophthalmology Physician
  • Sherman, TX
National Provider Identifier
1467461202
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
TEXAS RETINA ASSOCIATES
Practice address
715 E Taylor St
Sherman, TX 75090-2859
Phone
(903) 893-8443
NPI assigned
Aug 7, 2006
Last updated
May 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Authorized official

Name
Jefferey Brockette
Title
Ceo
Phone
(214) 692-6941

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

715 E Taylor St
Sherman, TX 75090-2859

Mailing address

PO Box 650037
Dallas, TX 75265-0037
Phone (214) 696-2008

Other identifiers 1

IdentifierTypeStateIssuer
094850706MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050221000018 TX Part B Supplier - Clinic/Group Practice 7012969843 Receives reassigned benefits from 18 practitioners
5 other NPIs on this enrollment
Practice locations: Dallas, TX; Woodway, TX; Wichita Falls, TX; Sherman, TX; Rockwall, TX; Plano, TX; Mansfield, TX; Lubbock, TX…

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Texas Retina Associates6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3324 Colorado Blvd
Ste 102
Denton, TX 76210
Phone (214) 369-0555

2380 S Goliad St
Ste 120
Rockwall, TX 75032
Phone (972) 722-4739

715 E Taylor St
Sherman, TX 75090
Phone (903) 893-8443

715 E Taylor St
Ste 100
Sherman, TX 75090
Phone (214) 360-0000

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1467461202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650037",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650037",
            "telephone_number": "214-696-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 E TAYLOR ST",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750902859",
            "telephone_number": "903-893-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS RETINA ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "BROCKETTE",
        "authorized_official_first_name": "JEFFEREY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-692-6941"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094850706",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.