Organization Active NPI

Lamm David Eyecare

  • Optometrist
  • San Angelo, TX
National Provider Identifier
1497024186
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
LAMM DAVID EYECARE
Practice address
3542A Loop 306
San Angelo, TX 76904-5944
Phone
(325) 653-0118
Fax
(325) 653-4347
NPI assigned
Dec 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

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

Authorized official

Name
Melinda Williamson
Title
Manager
Phone
(325) 653-0118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

3542A Loop 306
San Angelo, TX 76904-5944

Mailing address

3542A Loop 306
San Angelo, TX 76904-5944
Phone (325) 653-0118

Other identifiers 1

IdentifierTypeStateIssuer
093496001MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL staff@lammdavideyecare.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120418000242 TX Part B Supplier - Clinic/Group Practice 0244491272 Receives reassigned benefits from 3 practitioners
Practice locations: San Angelo, TX

National Provider Directory

National Provider Directory

Locations

2900 Golfside Dr
Ann Arbor, MI 48108
Phone (734) 434-5252

3542 Loop 306
San Angelo, TX 76904

1605 W Avenue N
San Angelo, TX 76904
Phone (325) 653-0118

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1324684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559865600000",
    "number": "1497024186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3542A LOOP 306",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769045944",
            "telephone_number": "325-653-0118",
            "fax_number": "325-653-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3542A LOOP 306",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769045944",
            "telephone_number": "325-653-0118",
            "fax_number": "325-653-4347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAMM DAVID EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-24",
        "last_updated": "2019-06-07",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "325-653-0118"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093496001",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "staff@lammdavideyecare.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3542A Loop 306",
            "city": "San Angelo",
            "state": "TX",
            "country_code": "US",
            "postal_code": "769045944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; 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.