Xinnan Wang

Primary specialty

OptometristTaxonomy code 152W00000X

License

9455T Issued in TX

Practice address

7108 Camp Bowie Blvd
Fort Worth, TX 76116-7198

Phone

(817) 738-3191

Fax

(817) 738-3191

NPI assigned

Jul 3, 2018

Last updated

Jul 3, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Houston - College of Optometry, 2018

Medicare assignment

May accept Medicare assignment

Group practices

Luck Optical LLCGroup PAC ID 8426285370, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Luck Optical LLC

  dba Luck Optical

  • Optometrist
  • Fort Worth, TX
  • NPI 1871926857
  Medicare reassignment Care Compare group NPD
• 2020 Eyedr

  dba Southlake Eyes Now

  • Optometrist
  • Southlake, TX
  • NPI 1942754700
  Medicare reassignment NPD
• Zanella Optometry, PLLC

  • Optometrist
  • Southlake, TX
  • NPI 1881759785
  NPD (past)

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

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1740776657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 CAMP BOWIE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167198",
            "telephone_number": "817-738-3191",
            "fax_number": "817-738-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7108 CAMP BOWIE BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167198",
            "telephone_number": "817-738-3191",
            "fax_number": "817-738-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "XINNAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9455T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Walz
• Julia Wambugu
• Shaoyu Wan
• Jason Wang, M.D.
• Virginia Tzu-En Wang, DMD
• Yen-Chung Jonathan Wang, DO
• Farah Wani, MD
• Warby Parker Inc.
• Karin Deann Warchocki, CRNA
• Lauren Sydney Ward-Reed, LMSW

• Optometrist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.