Jack Greenan

Primary specialty

OptometristTaxonomy code 152W00000X

License

9121T Issued in TX

Practice address

2703 Richmond Rd
Texarkana, TX 75503-2328

Phone

(903) 838-0783

NPI assigned

Dec 6, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR, TX2 enrollments

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 2

Specialty

Optometry

Education

Other, 2016

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)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aeg Texas Professional PLLC

  • Optometrist
  • Kerrville, TX
  • NPI 1457905937
  Medicare reassignment Care Compare group NPD
• Med Southwest, PLLC

  • Optometrist
  • Houston, TX
  • NPI 1609348739
  Medicare reassignment NPD
• Med Southwest, PLLC

  • Optometrist
  • Arkadelphia, AR
  • NPI 1497211783

  AR, Optometrist

  Medicare reassignment NPD
• Med Southwest, PLLC

  • Optometrist
  • Prosper, TX
  • NPI 1629613674
  NPD
• Med Southwest, PLLC

  • Optometrist
  • Oklahoma City, OK
  • NPI 1679440762
  NPD
• Dianne Bui Dao OD PC

  • Optometrist
  • Pearland, TX
  • NPI 1316159346
  NPD (past)
• Janet B Ogletree OD PA

  • Optometrist
  • Flower Mound, TX
  • NPI 1740313089
  NPD (past)
• Pope Enterprises PLLC

  • Optometrist
  • Friendswood, TX
  • NPI 1396927059
  NPD (past)

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

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1639613979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 RICHMOND RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 RICHMOND RD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755032328",
            "telephone_number": "903-838-0783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENAN",
        "first_name": "JACK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-06",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9121T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David E Greathouse, MD
• Sara Greathouse, WHNP
• Cathy Lynn Green, RNC, WHNP
• Faith Green, COTA
• Robert Clark Green, MD
• April Greenlee, ST
• John Reeves Gregory, M.D.
• Christina Michelle Griffin, PT
• John Stanley Griffin Jr., MD
• Nancy L Griffin, MD

• All providers in Texarkana, TX
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.