Individual provider Active NPI

Lorenzo Bryant Anderson, OD

  • Optometrist
  • McKinney, TX
National Provider Identifier
1740805795
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10047 Issued in TX
Practice address
1650 N Lake Forest Dr Ste 100
McKinney, TX 75071-7668
Phone
(972) 369-1411
Fax
(806) 791-4077
NPI assigned
Jun 15, 2020
Last updated
Nov 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10047 TX Primary

Addresses

Primary practice location

1650 N Lake Forest Dr Ste 100
McKinney, TX 75071-7668

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other practice location 1

3104 Indiana Ave
Lubbock, TX 79410-3148
Phone (806) 793-1927

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL vcwtsouth@gmail.com

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200623001336 TX Practitioner - Optometry 1254753148 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians

Practice addresses (Care Compare)

3605 Executive Dr
San Angelo, TX 76904-6884
Phone (325) 747-1511

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10047TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Sunset Eye Care P.C. Optometrist CurrentSince Oct 1, 2022 Accepting new patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Oct 30, 2021 Accepting new patients
Shannon Clinic CurrentSince Jan 24, 2024 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Oct 30, 2021 Accepting new patients

Locations

5560 W Lovers Ln
Ste 240
Dallas, TX 75209
Phone (469) 772-9700

6446 Lyndon B Johnson Fwy
Dallas, TX 75240
Phone (972) 960-2020

3104 Indiana Ave
Lubbock, TX 79410
Phone (803) 793-1927

1650 N Lake Forest Dr
Ste 100
McKinney, TX 75071
Phone (972) 369-1411

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

3605 Executive Dr
San Angelo, TX 76904
Phone (325) 949-9555

4241 Southwest Blvd
Ste 108
San Angelo, TX 76904
Phone (325) 949-6697

2703 Richmond Rd
Texarkana, TX 75503
Phone (903) 838-0783

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1740805795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 N LAKE FOREST DR STE 100",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750717668",
            "telephone_number": "972-369-1411",
            "fax_number": "806-791-4077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3104 Indiana Ave",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794103148",
            "country_code": "US",
            "telephone_number": "806-793-1927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LORENZO",
        "middle_name": "BRYANT",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-15",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "vcwtsouth@gmail.com",
            "affiliation": "N",
            "address_1": "3104 Indiana Ave",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794103148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in McKinney, TX

Sources for this page

Verify at the official NPI Registry.