Individual provider Active NPI

Juan Paulo Landaverde

  • Optician
  • Princeton, TX
National Provider Identifier
1649164443
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
264648 Issued in TX
Practice address
701 W Princeton Dr
Princeton, TX 75407-9002
Phone
(972) 736-6898
Fax
(972) 736-6909
NPI assigned
Jun 5, 2025
Last updated
Jun 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 264648 TX Primary

Addresses

Primary practice location

701 W Princeton Dr
Princeton, TX 75407-9002

Mailing address

701 W Princeton Dr
Princeton, TX 75407-9002
Phone (972) 736-6898

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
264648TXMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1649164443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W PRINCETON DR",
            "city": "PRINCETON",
            "state": "TX",
            "postal_code": "754079002",
            "telephone_number": "972-736-6898",
            "fax_number": "972-736-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W PRINCETON DR",
            "city": "PRINCETON",
            "state": "TX",
            "postal_code": "754079002",
            "telephone_number": "972-736-6898",
            "fax_number": "972-736-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDAVERDE",
        "first_name": "JUAN",
        "middle_name": "PAULO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "TX",
            "license": "264648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.