M D Jackman OD & Associates PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2404TG Issued in TX

Legal business name

M D JACKMAN OD & ASSOCIATES PLLC

Practice address

1000 W 39TH St
Austin, TX 78756-4008

Phone

(512) 323-6996

Fax

(512) 452-0015

NPI assigned

Jan 19, 2012

Organization subpart

No

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

Authorized official

Name

Merl D Jackman, OD

Title

Owner

Phone

(512) 323-6996

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Jackman Eye

  • Optometrist
  • Austin, TX
  • NPI 1740790336
  NPPES parent name

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anjali Patel, OD

  • Optometrist
  • Austin, TX
  • NPI 1578438826
  Medicare reassignment Care Compare group NPD
• Madison Luce Huser, O.D.

  • Optometrist
  • Wimberley, TX
  • NPI 1255684775
  Medicare reassignment Care Compare group
• Felicia Dea Satrio, O.D.

  • Optometrist
  • Austin, TX
  • NPI 1104318484
  Medicare reassignment Care Compare group
• Dee Ellyn Tekell, O.D.

  • Optometrist
  • Austin, TX
  • NPI 1154676435
  Medicare reassignment Care Compare group
• James Ashley Dugas, O.D.

  • Optometrist
  • Austin, TX
  • NPI 1538294848
  NPD (past)

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339632000000",
    "number": "1588935746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W 39TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787564008",
            "telephone_number": "512-323-6996",
            "fax_number": "512-452-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W 39TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787564008",
            "telephone_number": "512-323-6996",
            "fax_number": "512-452-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M D JACKMAN OD & ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-19",
        "last_updated": "2012-06-14",
        "status": "A",
        "authorized_official_last_name": "JACKMAN",
        "authorized_official_first_name": "MERL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-323-6996",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2404TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS OPTOMETRY LICENSE",
            "identifier": "2404TG",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "0083WW",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James A Lyttle, MD
• Yilin Lyu, M. ED, BCBA
• Yulia A Lyuboslavsky, APN, ACNS-BC
• M a Khan, PA
• M C Young Counseling PLLC
• M Francks Holdings LLC
• Janelly M Gomez
• M Medical LLC
• M Talo Wellness PLLC
• Jason Michael M Williamson, MS, LPC-ASSOCIATE,

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.