Individual provider Active NPI

George Green

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1477008274
Registry record updated Jan 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8993TG Issued in TX
Practice address
10003 NW Military Hwy Ste 3111
San Antonio, TX 78231-1891
Phone
(210) 355-3551
NPI assigned
Aug 22, 2016
Last updated
Jan 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8993TG TX Primary

Addresses

Primary practice location

10003 NW Military Hwy Ste 3111
San Antonio, TX 78231-1891

Mailing address

PO Box 745
Boerne, TX 78006-0745
Phone (210) 355-3551

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
I20160928000853 TX Practitioner - Optometry 0547557977 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians
University of the Incarnate WordGroup PAC ID 9234310301, 25 clinicians

Practice addresses (Care Compare)

1130 N Loop 1604
Suite 102
San Antonio, TX 78248-4507
Phone (210) 545-2020

9725 Datapoint Dr
San Antonio, TX 78229-2384
Phone (210) 283-6800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8993TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of the Incarnate Word Optometrist CurrentSince Aug 20, 2024 Accepting new patients
University of the Incarnate Word CurrentSince Aug 20, 2024 Accepting new patients
Eyemax Vision PLLC Optometrist CurrentSince Mar 18, 2022 Accepting new patients
Aeg Texas Professional PLLC Optometrist CurrentSince Aug 16, 2021 Accepting new patients
Dianne Bui Dao OD PC Optometrist PastSince Apr 24, 2011 Accepting new patients
Pope Enterprises PLLC Optometrist Past Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients
DRS. Bell, Davis, Elder & Assoc Optometrist Past Accepting new patients

Locations

3908 Far West Blvd
Austin, TX 78731
Phone (512) 343-0432

12320 Barker Cypress Rd
Ste 400
Cypress, TX 77429
Phone (281) 373-1020

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

1102 S Friendswood Dr
Ste A
Friendswood, TX 77546
Phone (281) 482-0066

6850 N Shiloh Rd
Ste T
Garland, TX 75044
Phone (972) 414-0444

2705 Broadway St
Ste 115
Pearland, TX 77581
Phone (281) 485-2020

10003 NW Military Hwy
Ste 3111
San Antonio, TX 78231
Phone (210) 355-3551

1130 N Loop 1604 W
Ste 102
San Antonio, TX 78248
Phone (210) 545-2020

1205 N Loop 1604 W
San Antonio, TX 78258
Phone (210) 319-2900

15677 San Pedro Ave
#B
San Antonio, TX 78232
Phone (210) 490-9205

7915 W Loop 1604 N
Ste 118
San Antonio, TX 78254
Phone (210) 257-0940

810 Knights Cross Dr
Ste 101
San Antonio, TX 78258
Phone (210) 495-9020

9218 Potranco Rd
Ste 105
San Antonio, TX 78251
Phone (210) 858-4001

9725 Datapoint Dr
San Antonio, TX 78229
Phone (210) 283-6800

9725 Datapoint Dr
#69
San Antonio, TX 78229
Phone (210) 283-6800

670 E Southlake Blvd
Southlake, TX 76092
Phone (817) 329-6466

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704585600000",
    "number": "1477008274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 745",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780060745",
            "telephone_number": "210-355-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10003 NW MILITARY HWY STE 3111",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782311891",
            "telephone_number": "210-355-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "GEORGE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-22",
        "last_updated": "2024-01-07",
        "certification_date": "2024-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8993TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.