Individual provider Active NPI

Gordon C. Hendricks, O.D., M.S.

  • Optometrist
  • El Paso, TX
National Provider Identifier
1578573754
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4814TG Issued in TX
Practice address
5001 N Piedras St
El Paso, TX 79930-4210
Phone
(915) 564-6116
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4814TG TX Primary

Addresses

Primary practice location

5001 N Piedras St
El Paso, TX 79930-4210

Mailing address

1024 Calle Milagro Dr
El Paso, TX 79912-7520
Phone (915) 842-9606

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
I20241010000586 TX Practitioner - Optometry 6507000221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

4775 Loma del Sur Dr
El Paso, TX 79934-3551
Phone (512) 889-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Goff & Falknor PA Optometrist CurrentSince Jul 26, 2024 Accepting new patients
Aeg Texas Professional PLLC Optometrist CurrentSince Jul 26, 2024 Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients

Locations

111 E 4th St
Ste 440
Alton, IL 62002

7410 Remcon Cir
El Paso, TX 79912

4775 Loma del Sur Dr
El Paso, TX 79934
Phone (512) 889-2020

7410 Remcon Cir
Ste K
El Paso, TX 79912
Phone (915) 587-9400

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

6850 N Shiloh Rd
Ste T
Garland, TX 75044
Phone (972) 414-0444

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578573754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 CALLE MILAGRO DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799127520",
            "telephone_number": "915-842-9606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 N PIEDRAS ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799304210",
            "telephone_number": "915-564-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "GORDON",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "O.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4814TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.