Active NPI
Aeg 4 TX Professional, PLLC
- Optometrist
- Dallas, TX
National Provider Identifier
1710748165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- AEG 4 TX PROFESSIONAL, PLLC
- Practice address
- 3636 McKinney Ave Ste 120
Dallas, TX 75204-1443 - Phone
- (214) 252-1800
- Fax
- (314) 741-4947
- NPI assigned
- Jan 22, 2024
- Last updated
- Jan 22, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Melissa K Allison
- Title
- Sr. Dir. MVC
- Phone
- (618) 462-9818
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
3636 McKinney Ave Ste 120
Dallas, TX 75204-1443
Mailing address
111 E 4TH St Ste 440
Alton, IL 62002-6206
Phone (618) 462-9818
Other practice location 1
5330 E Mockingbird Ln Ste 130
Dallas, TX 75206-0961
Phone (214) 341-9955
Other practice location 2
7324 Gaston Ave
Dallas, TX 75214-6126
Phone (214) 660-9830
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705881600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1705881600000",
"number": "1710748165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 E 4TH ST STE 440",
"city": "ALTON",
"state": "IL",
"postal_code": "620026206",
"telephone_number": "618-462-9818",
"fax_number": "314-741-4947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3636 MCKINNEY AVE STE 120",
"city": "DALLAS",
"state": "TX",
"postal_code": "752041443",
"telephone_number": "214-252-1800",
"fax_number": "314-741-4947"
}
],
"practiceLocations": [
{
"address_1": "5330 E Mockingbird Ln Ste 130",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752060961",
"country_code": "US",
"telephone_number": "214-341-9955",
"fax_number": "314-741-4947",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7324 Gaston Ave",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752146126",
"country_code": "US",
"telephone_number": "214-660-9830",
"fax_number": "314-741-4947",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "AEG 4 TX PROFESSIONAL, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-01-22",
"last_updated": "2024-01-22",
"certification_date": "2024-01-19",
"status": "A",
"authorized_official_last_name": "ALLISON",
"authorized_official_first_name": "MELISSA",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "SR. DIR. MVC",
"authorized_official_telephone_number": "618-462-9818"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
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- Advocate Healthcare Inc.
- Advocate Healthcare LLC (BrightWing Home Health)
- Aeg Texas Professional PLLC (Vision Arora)
- Aeg Texas Professional PLLC (Optix EyeCare & Gallery)
- Aegis Group Practice LLC
- Aeon Health, Inc.
- Aero Anesthesia PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.