Individual provider Active NPI

Lisa M Wilson, O.D.

  • Optometrist
  • Haslet, TX
National Provider Identifier
1861487613
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
13706 Issued in CA
Practice address
2432 Avondale Haslet Rd Ste 200
Haslet, TX 76052-3428
Phone
(817) 993-2020
NPI assigned
Sep 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 13706 CA Primary

Addresses

Primary practice location

2432 Avondale Haslet Rd Ste 200
Haslet, TX 76052-3428

Mailing address

2432 Avondale Haslet Rd Ste 200
Haslet, TX 76052-3428
Phone (817) 993-2020

Other identifiers 1

IdentifierTypeStateIssuer
11338TGOtherTXOPTOMETRIST

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
I20250628000083 TX Practitioner - Optometry 6406886175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Haslet Family Eyecare, PLLCGroup PAC ID 6507379039, 3 clinicians

Practice addresses (Care Compare)

2432 Avondale Haslet Rd
Suite 200
Haslet, TX 76052-3428
Phone (817) 993-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13706CAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Haslet Family Eyecare, PLLC Optometrist CurrentSince Jul 1, 2025 Accepting new patients

Locations

2432 Avondale Haslet Rd
Ste 200
Haslet, TX 76052
Phone (817) 369-5876

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1861487613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2432 AVONDALE HASLET RD STE 200",
            "city": "HASLET",
            "state": "TX",
            "postal_code": "760523428",
            "telephone_number": "817-993-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2432 AVONDALE HASLET RD STE 200",
            "city": "HASLET",
            "state": "TX",
            "postal_code": "760523428",
            "telephone_number": "817-993-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-19",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRIST",
            "identifier": "11338TG",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haslet, TX

Sources for this page

Verify at the official NPI Registry.