Individual provider Active NPI

Randall Bruce Cox, O.D.

  • Optometrist
  • Center, TX
National Provider Identifier
1568438372
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
01893TG Issued in TX
Practice address
810 Hurst St
Center, TX 75935-3417
Phone
(915) 204-4062
Fax
(936) 591-0876
NPI assigned
Feb 23, 2006
Last updated
Apr 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 01893TG TX Primary

Addresses

Primary practice location

810 Hurst St
Center, TX 75935-3417

Mailing address

810 Hurst St
Center, TX 75935-3417
Phone (915) 204-4062

Other identifiers 1

IdentifierTypeStateIssuer
151055401MedicaidTX

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
I20080506000227 TX Practitioner - Optometry 2062591886 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01893TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pineywoods Eye Associates P a Optometrist CurrentSince Feb 1, 2012 Accepting new patients
Pineywoods Eye Associates P a Optometrist CurrentSince Feb 1, 2012 Accepting new patients
Lincoln County Eye Center P C Past Accepting new patients

Locations

4729 NE Stallings Dr
Nacogdoches, TX 75965
Phone (936) 564-2634

Organizations & group practices 3

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1568438372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 HURST ST",
            "city": "CENTER",
            "state": "TX",
            "postal_code": "759353417",
            "telephone_number": "915-204-4062",
            "fax_number": "936-591-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 HURST ST",
            "city": "CENTER",
            "state": "TX",
            "postal_code": "759353417",
            "telephone_number": "915-204-4062",
            "fax_number": "936-591-0876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COX",
        "first_name": "RANDALL",
        "middle_name": "BRUCE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "01893TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151055401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Center, TX

Sources for this page

Verify at the official NPI Registry.