Organization Active NPI

East Texas Eye Care Associates PLLC

Doing business as The Optical Shop

  • Optician
  • Winnsboro, TX
National Provider Identifier
1528084142
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
EAST TEXAS EYE CARE ASSOCIATES PLLC
Doing business as
The Optical Shop
Practice address
408 S Main St
Winnsboro, TX 75494-3226
Phone
(903) 342-5799
Fax
(903) 342-1409
NPI assigned
Jul 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Authorized official

Name
Mrs. June Cheatham
Title
Administrator
Phone
(903) 595-0500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

408 S Main St
Winnsboro, TX 75494-3226

Mailing address

2440 E 5TH St
Tyler, TX 75701-3525
Phone (903) 595-0500

Other identifiers 1

IdentifierTypeStateIssuer
127242902MedicaidTX

Other names 1

  • The Optical Shop Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1528084142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 E 5TH ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013525",
            "telephone_number": "903-595-0500",
            "fax_number": "903-595-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 S MAIN ST",
            "city": "WINNSBORO",
            "state": "TX",
            "postal_code": "754943226",
            "telephone_number": "903-342-5799",
            "fax_number": "903-342-1409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS EYE CARE ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A",
        "authorized_official_last_name": "CHEATHAM",
        "authorized_official_first_name": "JUNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "903-595-0500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127242902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Optical Shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winnsboro, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.