Individual provider Active NPI

Glyn M Pearson, OD

  • Optometrist
  • Frisco, TX
National Provider Identifier
1679518856
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
05311TG Issued in TX
Practice address
2601 Preston Rd
Suite 2064
Frisco, TX 75034-9468
Phone
(972) 377-0700
Fax
(972) 377-0719
NPI assigned
Jun 19, 2006
Last updated
Jan 28, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 05311TG TX Primary

Addresses

Primary practice location

2601 Preston Rd
Suite 2064
Frisco, TX 75034-9468

Mailing address

4405 Giovanni Dr
Plano, TX 75024-3879

Other identifiers 1

IdentifierTypeStateIssuer
040420403MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20081211000844 TX Practitioner - Optometry 8123064664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
James a Williams O.D.P.C.Group PAC ID 1355442500, 10 clinicians

Practice addresses (Care Compare)

120 Town PL
Fairview, TX 75069-1822
Phone (972) 549-4255

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5311TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
James a Williams, OD, PC Optometrist CurrentSince Sep 15, 2021 Accepting new patients
James a Williams O.D.P.C. Current Accepting new patients
James a. Williams O.D.P.C. CurrentSince Sep 15, 2021 Accepting new patients
Craig a Bolton MD PA Past Accepting new patients
Allied Eye Associates, PC Optometrist PastSince Apr 21, 2003 Accepting new patients
Buthod Eye Care, PA Optometrist PastSince May 1, 2007 Accepting new patients

Locations

120 Town Pl
Fairview, TX 75069
Phone (972) 549-4255

2601 Preston Rd
Ste 2124
Frisco, TX 75034
Phone (972) 335-9332

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233100800000",
    "number": "1679518856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 GIOVANNI DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 PRESTON RD",
            "address_2": "SUITE 2064",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750349468",
            "telephone_number": "972-377-0700",
            "fax_number": "972-377-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "GLYN",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2009-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "05311TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040420403",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.