Individual provider Active NPI

Philip Fauria

  • Optometrist
  • Arlington, TX
National Provider Identifier
1821489063
Registry record updated Feb 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8624T Issued in TX
Practice address
5520 S Cooper St
Suite 110
Arlington, TX 76017-4404
Phone
(817) 467-2020
Fax
(817) 375-8210
NPI assigned
Feb 10, 2015
Last updated
Feb 10, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8624T TX Primary

Addresses

Primary practice location

5520 S Cooper St
Suite 110
Arlington, TX 76017-4404

Mailing address

5520 S Cooper St
Suite 110
Arlington, TX 76017-4404
Phone (817) 467-2020

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
I20150325001173 TX Practitioner - Optometry 3870810138 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8624TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dann Martin O.D.,P.a. Optometrist CurrentSince Mar 3, 2015 Accepting new patients

Locations

5520 S Cooper St
Ste 110
Arlington, TX 76017
Phone (817) 467-2020

Organizations & group practices 1

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": "1423526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423526400000",
    "number": "1821489063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 S COOPER ST",
            "address_2": "SUITE 110",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760174404",
            "telephone_number": "817-467-2020",
            "fax_number": "817-375-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 S COOPER ST",
            "address_2": "SUITE 110",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760174404",
            "telephone_number": "817-467-2020",
            "fax_number": "817-375-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAURIA",
        "first_name": "PHILIP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-10",
        "last_updated": "2015-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8624T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

Verify at the official NPI Registry.