Individual provider Active NPI

Paul G. Middleton, OD

  • Optometrist
  • Denton, TX
National Provider Identifier
1578709762
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
05259T Issued in TX
Practice address
2210 San Jacinto Blvd
Denton, TX 76205-7527
Phone
(940) 382-8000
Fax
(940) 383-2608
NPI assigned
Dec 18, 2008
Last updated
Jan 20, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 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 05259T TX Primary

Addresses

Primary practice location

2210 San Jacinto Blvd
Denton, TX 76205-7527

Mailing address

2210 San Jacinto Blvd
Suite 1
Denton, TX 76205-7527
Phone (940) 382-8000

Other identifiers 1

IdentifierTypeStateIssuer
05259TOtherTXTEXAS OPTOMETRY BOARD

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
I20120327000301 TX Practitioner - Optometry 2961662101 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1996
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)

3111 Unicorn Lake Blvd
Suite 100
Denton, TX 76210-0118
Phone (940) 891-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5259TXMDBehavioral Analyst
05259TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Texas Professional PLLC Optometrist CurrentSince Dec 6, 2021 Accepting new patients
Lawrence a. Shafron MD PA CurrentSince Jan 1, 2012 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

2210 San Jacinto Blvd
Ste 1
Denton, TX 76205
Phone (940) 382-8000

3111 Unicorn Lake Blvd
Ste 100
Denton, TX 76210
Phone (940) 891-3937

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

670 E Southlake Blvd
Southlake, TX 76092
Phone (817) 329-6466

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": "1229558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1578709762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 SAN JACINTO BLVD",
            "address_2": "SUITE 1",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762057527",
            "telephone_number": "940-382-8000",
            "fax_number": "940-383-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 SAN JACINTO BLVD",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762057527",
            "telephone_number": "940-382-8000",
            "fax_number": "940-383-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "PAUL",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-18",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "05259T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS OPTOMETRY BOARD",
            "identifier": "05259T",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

Verify at the official NPI Registry.