Young Optical

Primary specialty

Optometric Assistant TechnicianTaxonomy code 156FX1201X

Legal business name

YOUNG OPTICAL

Practice address

226 Coleman
Ste 103
Marlin, TX 76661

Phone

(254) 883-3051

Fax

(254) 803-3487

NPI assigned

Feb 2, 2008

Last updated

Jul 22, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dorothy Jane Young

Title

Owner Manager

Phone

(254) 883-3051

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1201910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1689852535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80",
            "city": "MARLIN",
            "state": "TX",
            "postal_code": "766610080",
            "telephone_number": "254-883-3051",
            "fax_number": "254-803-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 COLEMAN",
            "address_2": "STE 103",
            "city": "MARLIN",
            "state": "TX",
            "postal_code": "76661",
            "telephone_number": "254-883-3051",
            "fax_number": "254-803-3487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-02",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "OWNER MANAGER",
        "authorized_official_telephone_number": "254-883-3051"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "156FX1201X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optometric Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066494801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Renee Trujillo, FNP
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• Stephanie Wetsel, M.S. CCC-SLP
• Charlotte Irene Widick, ENP

• Technician/Technologist in Marlin, TX
• Providers in Marlin, TX by specialty
• Technician/Technologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.