Organization Active NPI

Advanced Eye Care of Texas PLLC

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1528338472
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7565TG Issued in TX
Legal business name
ADVANCED EYE CARE OF TEXAS PLLC
Practice address
9500 Clifford St
Fort Worth, TX 76108-4403
Phone
(817) 367-7100
Fax
(817) 367-7102
NPI assigned
Jan 10, 2012
Last updated
Jan 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Authorized official

Name
Tuanh La, ODNPI 1538472683
Title
Member
Phone
(214) 727-6542

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7565TG TX Primary

Addresses

Primary practice location

9500 Clifford St
Fort Worth, TX 76108-4403

Mailing address

9500 Clifford St
Fort Worth, TX 76108-4403
Phone (817) 367-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120413000055 TX Part B Supplier - Clinic/Group Practice 9739340035 Receives reassigned benefits from 6 practitioners
Practice locations: Fort Worth, TX; Mansfield, TX

National Provider Directory

National Provider Directory

Locations

1450 Eastchase Pkwy
Ste 100B
Fort Worth, TX 76120

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1528338472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 CLIFFORD ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761084403",
            "telephone_number": "817-367-7100",
            "fax_number": "817-367-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 CLIFFORD ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761084403",
            "telephone_number": "817-367-7100",
            "fax_number": "817-367-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED EYE CARE OF TEXAS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "LA",
        "authorized_official_first_name": "TUANH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "214-727-6542",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7565TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.