Individual provider Active NPI

Daniel R Vanlaningham, O.D.

  • Optometrist
  • Bryan, TX
National Provider Identifier
1528149374
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5628T Issued in TX
Practice address
2200 Briarcrest Dr
Ste 106
Bryan, TX 77802-5000
Phone
(979) 774-5400
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5628T TX Primary

Addresses

Primary practice location

2200 Briarcrest Dr
Ste 106
Bryan, TX 77802-5000

Mailing address

2200 Briarcrest Dr
Ste 106
Bryan, TX 77802-5000
Phone (979) 774-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120430000571 TX Practitioner - Optometry 7416118286 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5628TTXMDOptometrist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1528149374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 BRIARCREST DR",
            "address_2": "STE 106",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025000",
            "telephone_number": "979-774-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BRIARCREST DR",
            "address_2": "STE 106",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025000",
            "telephone_number": "979-774-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANLANINGHAM",
        "first_name": "DANIEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5628T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.