Modesto Macogay Bala III, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

9803 Issued in TX

Practice address

229 Ih 45 S Ste H
Huntsville, TX 77340-4988

Phone

(936) 755-7740

NPI assigned

Feb 20, 2019

Last updated

Apr 25, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• National Vision Inc

  dba America's Best Contacts & Eyeglasses

  • Optometrist
  • Huntsville, TX
  • NPI 1013581453
  NPD
• Timothy E. Kale Optometrist, Inc

  dba All Eyes

  • Optometrist
  • Kealakekua, HI
  • NPI 1386819563
  NPD (past)

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1558827030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 SAM HOUSTON AVE APT 518",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773406674",
            "telephone_number": "808-319-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 IH 45 S STE H",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404988",
            "telephone_number": "936-755-7740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "79-7407 Mamalahoa Hwy Spc Ef",
            "address_purpose": "LOCATION",
            "city": "Kealakekua",
            "state": "HI",
            "postal_code": "967507931",
            "country_code": "US",
            "telephone_number": "808-322-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALA",
        "first_name": "MODESTO",
        "middle_name": "MACOGAY",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-20",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "HI",
            "license": "OD-901",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aurra Pharmacy LLC
• B.J. Atkins, M.D., P.a.
• Olufunmilola Babarinde, MD,MPH
• Melinda Spillers Bacak
• Back Pain & Sciatica Center of Huntsville PLLC
• Amina Baldwin, SLPA
• Nurunnisa Banu, MD
• Basic Balance Nutrition, Inc.
• Bayes Achievement Center, Inc.
• Monica Erin Bayes, LPC

• Optometrist in Huntsville, TX
• Providers in Huntsville, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; 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.