Active NPI
Sebi Chung, O.D.
- Optometrist
- San Antonio, TX
National Provider Identifier
1629105341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5772T
- Practice address
- 6035 NW Loop 410 Ste a
San Antonio, TX 78238-3301 - Phone
- (210) 509-4779
- Fax
- (210) 680-3438
- NPI assigned
- Feb 28, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 5772T | TX | Primary |
Addresses
Primary practice location
6035 NW Loop 410 Ste a
San Antonio, TX 78238-3301
Mailing address
19702 Ranch MDWS
San Antonio, TX 78258-3824
Phone (210) 659-2526
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190827001844 | TX | Practitioner - Optometry | 2567790686 | Practice locations: Selma, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629105341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19702 RANCH MDWS",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782583824",
"telephone_number": "210-659-2526",
"fax_number": "210-657-7205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6035 NW LOOP 410 STE A",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782383301",
"telephone_number": "210-509-4779",
"fax_number": "210-680-3438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "SEBI",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "5772T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.