NPIMap

Organization Active NPI

20-20 Express--Dallas LLC

  • Eyewear Supplier
  • Fort Worth, TX
National Provider Identifier
1669873857
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
20-20 EXPRESS--DALLAS LLC
Practice address
4614 SW Loop 820
Fort Worth, TX 76109-4418
Phone
(817) 732-2706
Fax
(972) 277-3176
NPI assigned
Sep 8, 2014
Organization subpart
Yes
Parent organization
20-20 EXPRESS--DALLAS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Authorized official

Name
Karen Pittman
Title
Director of Managed Care
Phone
(920) 997-1583

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

4614 SW Loop 820
Fort Worth, TX 76109-4418

Mailing address

4614 SW Loop 820
Fort Worth, TX 76109-4418
Phone (817) 732-2706

National Provider Directory

National Provider Directory
Part of
2020 Express-Dallas LLC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4614 SW Loop 820
Ft Worth, TX 76109
Phone (817) 732-2706

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433376000000",
    "number": "1669873857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4614 SW LOOP 820",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094418",
            "telephone_number": "817-732-2706",
            "fax_number": "972-277-3176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4614 SW LOOP 820",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094418",
            "telephone_number": "817-732-2706",
            "fax_number": "972-277-3176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "20-20 EXPRESS--DALLAS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "20-20 EXPRESS--DALLAS LLC",
        "enumeration_date": "2014-09-08",
        "last_updated": "2015-06-04",
        "status": "A",
        "authorized_official_last_name": "PITTMAN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE",
        "authorized_official_telephone_number": "920-997-1583"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; 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.