Individual provider Active NPI

Lance M Chong, O.D.

  • Optometrist
  • Garland, TX
National Provider Identifier
1821190141
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5771TG Issued in TX
Practice address
2930 S 1St St Ste 700
Garland, TX 75041-3452
Phone
(972) 278-0154
Fax
(972) 278-8327
NPI assigned
Sep 5, 2006
Last updated
Nov 16, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5771TG TX Primary

Addresses

Primary practice location

2930 S 1St St Ste 700
Garland, TX 75041-3452

Mailing address

2930 S 1St St Ste 700
Garland, TX 75041-3452
Phone (972) 278-0154

Other identifiers 1

IdentifierTypeStateIssuer
019139702MedicaidTX

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
I20091228000583 TX Practitioner - Optometry 5193865087 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2930 S 1St St
Suite 700
Garland, TX 75041-3452
Phone (972) 278-0154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5771TXMDChiropractor
5771TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Eye Center LLC Optometrist CurrentSince Jun 1, 2021 Accepting new patients
Park Forest Optical LLC Optometrist CurrentSince Jul 1, 2021 Accepting new patients

Locations

11722 Marsh Ln
Ste 350
Dallas, TX 75229
Phone (214) 902-9777

5502 Broadway Blvd
Garland, TX 75043
Phone (214) 887-3937

Organizations & group practices 3

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1821190141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 S 1ST ST STE 700",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750413452",
            "telephone_number": "972-278-0154",
            "fax_number": "972-278-8327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 S 1ST ST STE 700",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750413452",
            "telephone_number": "972-278-0154",
            "fax_number": "972-278-8327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONG",
        "first_name": "LANCE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5771TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019139702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.