Jose Miguel Correa-Dieguez, O.D.
Individual provider Active NPI Optometrist · Texas City, TX
NPI 1700218930 · NPPES record last updated Feb 10, 2025
Key facts
- NPI
- 1700218930
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 8288-T (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
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Texas City Eye Consultants PLLC
Practice addresses (Care Compare)
2506 25TH Ave N
Suite 3
Texas City, TX 77590-4666
Phone (409) 945-5511
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140115000695 | TX | Practitioner - Optometry | 4284862467 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8288-T | TX | MD | Glaucoma Specialist (Ophthalmology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas City Eye Consultants PLLC | Optometrist | Current |
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | 8288-T | TX | |
| Glaucoma Specialist (Ophthalmology) Physician | 207WX0009X | 8288-T | TX | |
| Optometrist | 152W00000X | 8288-T | TX | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 326469ZMAC | Medicaid | TX |
Other providers in Texas City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.