NPIMap

Organization Active NPI

Todd Brantley, OD PA

Doing business as Lone Star Vision

  • Optometrist
  • Plano, TX
National Provider Identifier
1790931632
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5711TG Issued in TX
Legal business name
TODD BRANTLEY, OD PA
Doing business as
Lone Star Vision
Practice address
5425 W Spring Creek Pkwy
Suite 145
Plano, TX 75024-4236
Phone
(972) 378-4104
Fax
(972) 378-9094
NPI assigned
Aug 12, 2008
Last updated
Jun 7, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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

Authorized official

Name
Dr. Todd Brantley, O.D.NPI 1760595631
Title
Owner
Phone
(972) 378-4104

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 5711TG TX Primary

Addresses

Primary practice location

5425 W Spring Creek Pkwy
Suite 145
Plano, TX 75024-4236

Mailing address

5425 W Spring Creek Pkwy
Suite 145
Plano, TX 75024-4236
Phone (972) 378-4104

Other names 1

  • Lone Star Vision Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100326000947 TX Part B Supplier - Clinic/Group Practice 4284760414 Receives reassigned benefits from 9 practitioners
Practice locations: Plano, TX

National Provider Directory

National Provider Directory
Tax ID family
Lone Star Vision2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5425 W Spring Creek Pkwy
Ste 145
Plano, TX 75024
Phone (214) 382-5100

5960 W Parker Rd
Ste 228
Plano, TX 75093
Phone (972) 378-4055

Practitioners & affiliated clinicians

Practitioners 9

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": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339027200000",
    "number": "1790931632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 W SPRING CREEK PKWY",
            "address_2": "SUITE 145",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750244236",
            "telephone_number": "972-378-4104",
            "fax_number": "972-378-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 W SPRING CREEK PKWY",
            "address_2": "SUITE 145",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750244236",
            "telephone_number": "972-378-4104",
            "fax_number": "972-378-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TODD BRANTLEY, OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2012-06-07",
        "status": "A",
        "authorized_official_last_name": "BRANTLEY",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-378-4104",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5711TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lone Star Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; 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.