Individual provider Active NPI

Mano Greg Valderaz, O.D.

  • Optometrist
  • Live Oak, TX
National Provider Identifier
1487780573
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6912TG Issued in TX
Practice address
11465 Toepperwein Rd
Live Oak, TX 78233-3138
Phone
(210) 590-3333
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 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 6912TG TX Primary

Addresses

Primary practice location

11465 Toepperwein Rd
Live Oak, TX 78233-3138

Mailing address

11465 Toepperwein Rd
Live Oak, TX 78233-3138
Phone (210) 590-3333

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
I20080721000138 TX Practitioner - Optometry 5395818603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11465 Toepperwein Rd
Live Oak, TX 78233-3138
Phone (210) 590-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6912TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
In Focus Eyecare Optometrist CurrentSince Jun 2, 2008 Accepting new patients
Abdep LP Optometrist Past Accepting new patients
Aeg Texas Professional PLLC Optometrist Past Accepting new patients
DRS. Bell, Davis, Elder & Assoc Optometrist Past Accepting new patients

Locations

11465 Toepperwein Rd
Live Oak, TX 78233
Phone (210) 599-9570

12215 Toepperwein Rd
Ste 200
Live Oak, TX 78233
Phone (210) 590-3333

931 N Business Ih 35
Ste 1
New Braunfels, TX 78130
Phone (830) 302-3939

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1487780573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11465 TOEPPERWEIN RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333138",
            "telephone_number": "210-590-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11465 TOEPPERWEIN RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333138",
            "telephone_number": "210-590-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDERAZ",
        "first_name": "MANO",
        "middle_name": "GREG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6912TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

Verify at the official NPI Registry.