Individual provider Active NPI

Jeffery B Wood

  • Optometrist
  • Allen, TX
National Provider Identifier
1548359045
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3241TG Issued in TX
Practice address
321 N Allen Dr
Allen, TX 75013-2539
Phone
(972) 727-5717
Fax
(972) 727-9927
NPI assigned
Oct 12, 2006
Last updated
Jun 22, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3241TG TX Primary

Addresses

Primary practice location

321 N Allen Dr
Allen, TX 75013-2539

Mailing address

321 N Allen Dr
Allen, TX 75013-2539
Phone (972) 727-5717

Other identifiers 1

IdentifierTypeStateIssuer
093398803MedicaidTX

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
I20120606000282 TX Practitioner - Optometry 1153439526 Reassigns benefits to 1 organization
Receives reassigned benefits from 2 practitioners
Practice locations: Allen, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3241TXMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Brooks Wood Eyecare LLC Optometrist CurrentSince Jul 26, 2021 Accepting new patients

Locations

321 N Allen Dr
Allen, TX 75013
Phone (972) 727-5717

Practitioners & affiliated clinicians

Practitioners 2

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.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1548359045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N ALLEN DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750132539",
            "telephone_number": "972-727-5717",
            "fax_number": "972-727-9927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N ALLEN DR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750132539",
            "telephone_number": "972-727-5717",
            "fax_number": "972-727-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "JEFFERY",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3241TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093398803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

Verify at the official NPI Registry.