NPIMap

Organization Active NPI

Michael Ray Gerdts LTD

Doing business as Vision Source - Research Forest

  • Optometrist
  • Shenandoah, TX
National Provider Identifier
1669606349
Registry record updated May 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6836T Issued in TX
Legal business name
MICHAEL RAY GERDTS LTD
Doing business as
Vision Source - Research Forest
Practice address
1508 Research Forest Dr
Suite 200
Shenandoah, TX 77381-4374
Phone
(281) 466-1700
Fax
(281) 466-1704
NPI assigned
May 8, 2009
Last updated
May 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2009

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

Authorized official

Name
Michael R. Gerdts, ODNPI 1982794814
Title
Doctor of Optometry
Phone
(281) 466-1700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 6836T TX Primary

Addresses

Primary practice location

1508 Research Forest Dr
Suite 200
Shenandoah, TX 77381-4374

Mailing address

1508 Research Forest Dr
Suite 200
Shenandoah, TX 77381-4374
Phone (281) 466-1700

Other identifiers 1

IdentifierTypeStateIssuer
6836TOtherTXTEXAS OPTOMETRY LICENSE

Other names 1

  • VISION SOURCE - RESEARCH FOREST Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241740800000",
    "number": "1669606349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 RESEARCH FOREST DR",
            "address_2": "SUITE 200",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773814374",
            "telephone_number": "281-466-1700",
            "fax_number": "281-466-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 RESEARCH FOREST DR",
            "address_2": "SUITE 200",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773814374",
            "telephone_number": "281-466-1700",
            "fax_number": "281-466-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL RAY GERDTS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-08",
        "last_updated": "2009-05-08",
        "status": "A",
        "authorized_official_last_name": "GERDTS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "DOCTOR OF OPTOMETRY",
        "authorized_official_telephone_number": "281-466-1700",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6836T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS OPTOMETRY LICENSE",
            "identifier": "6836T",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VISION SOURCE - RESEARCH FOREST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shenandoah, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2009; 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.