North Texas Optometry, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

4905TG Issued in TX

Legal business name

NORTH TEXAS OPTOMETRY, PLLC

Practice address

201 Commerce St
Childress, TX 79201-4523

Phone

(940) 393-0438

NPI assigned

Sep 20, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jerry S Young, ODNPI 1992793764

Title

Owner/Optometrist

Phone

(940) 937-4090

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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.

• Jerry Steven Young, OD

  • Optometrist
  • Childress, TX
  • NPI 1992793764
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1508375791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 COMMERCE ST",
            "city": "CHILDRESS",
            "state": "TX",
            "postal_code": "792014523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 COMMERCE ST",
            "city": "CHILDRESS",
            "state": "TX",
            "postal_code": "792014523",
            "telephone_number": "940-393-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH TEXAS OPTOMETRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "940-937-4090",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4905TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mincy Mathew
• Stacie Brooke Mathis, LCSW
• Med-Trans Corporation
• Ricky L. Nall, D.C.
• Nicholas Souder, MD, P.a.
• Honorato P Olay Jr., M.D.
• Dennis J Oneill, CRNA
• Dustin Robert Pratt, M.D.
• Leann Kristine Preston, DNP, APRN, FNP-C
• Prohealth Partners LLC (Cottage Village of Childress)

• Optometrist in Childress, TX
• Providers in Childress, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.