Organization Active NPI

Anna Eyecare, PA

  • Optometrist
  • Anna, TX
National Provider Identifier
1730410952
Registry record updated May 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ANNA EYECARE, PA
Practice address
805 W. White Street
Anna, TX 75409-2714
Phone
(972) 924-8889
Fax
(972) 924-8555
NPI assigned
Jan 28, 2010
Last updated
May 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2011

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

Authorized official

Name
Dr. Christopher R Jackman, O.D.NPI 1730319146
Title
President
Phone
(972) 924-8889

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

805 W. White Street
Anna, TX 75409-2714

Mailing address

805 W White St
Suite 100
Anna, TX 75409-2614
Phone (972) 924-8889

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100323000559 TX Part B Supplier - Clinic/Group Practice 9234264722 Receives reassigned benefits from 1 practitioner
Practice locations: Anna, TX

National Provider Directory

National Provider Directory

Locations

1108 W White St
Ste 200
Anna, TX 75409
Phone (972) 924-8889

805 W White St
Anna, TX 75409
Phone (972) 924-8889

805 W White St
Ste 100
Anna, TX 75409
Phone (972) 924-8889

Practitioners & affiliated clinicians

Practitioners 1

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": "1264636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306454400000",
    "number": "1730410952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W WHITE ST",
            "address_2": "SUITE 100",
            "city": "ANNA",
            "state": "TX",
            "postal_code": "754092614",
            "telephone_number": "972-924-8889",
            "fax_number": "972-924-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W. WHITE STREET",
            "city": "ANNA",
            "state": "TX",
            "postal_code": "754092714",
            "telephone_number": "972-924-8889",
            "fax_number": "972-924-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNA EYECARE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-28",
        "last_updated": "2011-05-27",
        "status": "A",
        "authorized_official_last_name": "JACKMAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-924-8889",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anna, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; 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.