NPIMap

Organization Active NPI

Charles L. Heaton, MD, PA

  • Optician
  • Longview, TX
National Provider Identifier
1649575291
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
CHARLES L. HEATON, MD, PA
Practice address
1205 N 6TH St
Longview, TX 75601-5539
Phone
(903) 234-0771
Fax
(903) 234-0775
NPI assigned
Jan 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Authorized official

Name
Judith Hodges-Odom
Title
Credentialing Specialist
Phone
(903) 526-0444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FX1800X Primary

Addresses

Primary practice location

1205 N 6TH St
Longview, TX 75601-5539

Mailing address

3415 Golden Rd
Tyler, TX 75701-8355
Phone (903) 526-0444

Other names 1

  • Heaton Eye Associates Optical Shop Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Heaton Eye Asso5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

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.

NPI Registry JSON

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1649575291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 GOLDEN RD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018355",
            "telephone_number": "903-526-0444",
            "fax_number": "903-526-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 N 6TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756015539",
            "telephone_number": "903-234-0771",
            "fax_number": "903-234-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES L. HEATON, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-12",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "HODGES-ODOM",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "903-526-0444"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heaton Eye Associates Optical Shop",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heaton Eye Associates Optical Shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; 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.