B J Pittman OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

2241TG Issued in TX

Legal business name

B J PITTMAN OD PA

Practice address

62 N Cameron St
Alice, TX 78332-4953

Phone

(361) 664-3571

Fax

(361) 664-3502

NPI assigned

Apr 13, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Addi Pittman

Title

Office MGR.

Phone

(830) 626-0943

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544832000000",
    "number": "1497071690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 INDIAN MOON CV",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781323396",
            "telephone_number": "830-626-0943",
            "fax_number": "830-626-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 N CAMERON ST",
            "city": "ALICE",
            "state": "TX",
            "postal_code": "783324953",
            "telephone_number": "361-664-3571",
            "fax_number": "361-664-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B J PITTMAN OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-13",
        "last_updated": "2018-12-15",
        "status": "A",
        "authorized_official_last_name": "PITTMAN",
        "authorized_official_first_name": "ADDI",
        "authorized_official_title_or_position": "OFFICE MGR.",
        "authorized_official_telephone_number": "830-626-0943",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2241TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121630103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Alice, TX
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2018; 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.