Organization Active NPI

The Eye Group of Texas LLC

  • Optometrist
  • Southlake, TX
National Provider Identifier
1720026719
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3413TG Issued in TX
Legal business name
THE EYE GROUP OF TEXAS LLC
Practice address
3105 E Southlake Blvd
Southlake, TX 76092-6621
Phone
(817) 310-3989
Fax
(817) 346-6998
NPI assigned
Jun 3, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Lena WF Chu, O.D.
Title
Owner
Phone
(817) 310-3989

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3413TG TX Primary

Addresses

Primary practice location

3105 E Southlake Blvd
Southlake, TX 76092-6621

Mailing address

3105 E Southlake Blvd
Southlake, TX 76092-6621
Phone (817) 310-3989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080505000065 TX Part B Supplier - Clinic/Group Practice 7012096928 Receives reassigned benefits from 11 practitioners
Practice locations: Southlake, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720026719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 E SOUTHLAKE BLVD",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926621",
            "telephone_number": "817-310-3989",
            "fax_number": "817-346-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 E SOUTHLAKE BLVD",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926621",
            "telephone_number": "817-310-3989",
            "fax_number": "817-346-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EYE GROUP OF TEXAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHU",
        "authorized_official_first_name": "LENA",
        "authorized_official_middle_name": "WF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-310-3989",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3413TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.