Individual provider Active NPI

Jose Miguel Correa-Dieguez, O.D.

  • Optometrist
  • Texas City, TX
National Provider Identifier
1700218930
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8288-T Issued in TX
Practice address
2506 25TH Ave N Ste 3
Texas City, TX 77590-4666
Phone
(409) 945-5511
Fax
(409) 945-5385
NPI assigned
Jul 30, 2013
Last updated
Feb 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 8288-T TX
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X 8288-T TX
Optometrist 152W00000X 8288-T TX Primary

Addresses

Primary practice location

2506 25TH Ave N Ste 3
Texas City, TX 77590-4666

Mailing address

2506 25TH Ave N Ste 3
Texas City, TX 77590-4666
Phone (409) 945-5511

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
I20140115000695 TX Practitioner - Optometry 4284862467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas City Eye Consultants PLLCGroup PAC ID 4183949407, 4 clinicians

Practice addresses (Care Compare)

2506 25TH Ave N
Suite 3
Texas City, TX 77590-4666
Phone (409) 945-5511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8288-TTXMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas City Eye Consultants PLLC Optometrist CurrentSince Dec 12, 2014 Accepting new patients
Vision Center of Texas, PA Past Accepting new patients

Locations

2506 25th Ave N
Ste 3
Texas City, TX 77590
Phone (409) 945-5511

Organizations & group practices 2

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": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1700218930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 25TH AVE N STE 3",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775904666",
            "telephone_number": "409-945-5511",
            "fax_number": "409-945-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2506 25TH AVE N STE 3",
            "city": "TEXAS CITY",
            "state": "TX",
            "postal_code": "775904666",
            "telephone_number": "409-945-5511",
            "fax_number": "409-945-5385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA-DIEGUEZ",
        "first_name": "JOSE",
        "middle_name": "MIGUEL",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-30",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "8288-T",
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "TX",
            "license": "8288-T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8288-T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Texas City, TX

Sources for this page

Verify at the official NPI Registry.