Active NPI
Sam's Club Optical
Doing business as Sam's Club Optical 30-8126
- Eyewear Supplier
- Brownsville, TX
National Provider Identifier
1508953290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- Legal business name
- SAM'S CLUB OPTICAL
- Doing business as
- Sam's Club Optical 30-8126
- Practice address
- 3570 W Alton Gloor Blvd
Brownsville, TX 78520-9286 - Phone
- (956) 350-9736
- Fax
- (956) 350-9736
- NPI assigned
- Oct 6, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kimberly Canonic
- Title
- Senior Director
- Phone
- (480) 853-0515
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | |||
| Eyewear Supplier | 332H00000X | Primary |
Addresses
Primary practice location
3570 W Alton Gloor Blvd
Brownsville, TX 78520-9286
Mailing address
1 Customer Dr
Bentonville, AR 72716-0445
Other names 1
- Sam's Club Optical 30-8126
National Provider Directory
National Provider Directory- Tax ID family
- Sam's Hearing Aid Center 6332
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1787788800000",
"number": "1508953290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CUSTOMER DR",
"city": "BENTONVILLE",
"state": "AR",
"postal_code": "727160445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3570 W ALTON GLOOR BLVD",
"city": "BROWNSVILLE",
"state": "TX",
"postal_code": "785209286",
"telephone_number": "956-350-9736",
"fax_number": "956-350-9736"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAM'S CLUB OPTICAL",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-06",
"last_updated": "2026-08-27",
"certification_date": "2026-08-27",
"status": "A",
"authorized_official_last_name": "CANONIC",
"authorized_official_first_name": "KIMBERLY",
"authorized_official_title_or_position": "SENIOR DIRECTOR",
"authorized_official_telephone_number": "480-853-0515"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": null,
"primary": false
},
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Sam's Club Optical 30-8126",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Brownsville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.