Dr. Alan C. Larsen, Optometrist, P.L.L.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3962-TG Issued in TX

Legal business name

DR. ALAN C. LARSEN, OPTOMETRIST, P.L.L.C.

Practice address

2705 Sherwood Way
San Angelo, TX 76901-3091

Phone

(325) 949-5750

Fax

(325) 227-8254

NPI assigned

Jan 26, 2016

Organization subpart

No

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

Authorized official

Name

Alan C Larsen, OD

Title

Optometrist, Owner

Phone

(325) 949-5750

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603411200000",
    "number": "1700243458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 SHERWOOD WAY",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769013091",
            "telephone_number": "325-949-5750",
            "fax_number": "325-227-8254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 SHERWOOD WAY",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769013091",
            "telephone_number": "325-949-5750",
            "fax_number": "325-227-8254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. ALAN C. LARSEN, OPTOMETRIST, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-26",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OPTOMETRIST, OWNER",
        "authorized_official_telephone_number": "325-949-5750",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3962-TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093364001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.