Paul Steven Black O.D. P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2821 Issued in TX

Legal business name

PAUL STEVEN BLACK O.D. P.A.

Practice address

111 Interstate 45 S
Suite D
Huntsville, TX 77340-4244

Phone

(936) 291-2770

Fax

(936) 291-7422

NPI assigned

Jul 20, 2012

Organization subpart

No

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

Authorized official

Name

Paul Steven Black, O.D.

Title

President

Phone

(936) 291-2770

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342742400000",
    "number": "1699020115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 INTERSTATE 45 S",
            "address_2": "SUITE D",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404243",
            "telephone_number": "936-291-2770",
            "fax_number": "936-291-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 INTERSTATE 45 S",
            "address_2": "SUITE D",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773404244",
            "telephone_number": "936-291-2770",
            "fax_number": "936-291-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL STEVEN BLACK O.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-20",
        "last_updated": "2012-07-20",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-291-2770",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124695014",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krina Patel, PHARMD, BCPP
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• Sarin M. Patel, PHARMD
• Sonal Arvind Patel, MD
• Patriotic Home Health, Inc.
• Paul Steven Black, O.D.
• Peck Chiropractic & Rehabilitation Clinic PA
• Michael J Peck, D.C.
• Justin Pedigo, PHARMD
• Hillary J Peebles, PHARMD

• Optometrist in Huntsville, TX
• Providers in Huntsville, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; 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.