Organization Active NPI

Nicole a. Mueller P.a.

Doing business as Granbury Eye Clinic

  • Ophthalmology Physician
  • Granbury, TX
National Provider Identifier
1861491037
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
NICOLE A. MUELLER P.A.
Doing business as
Granbury Eye Clinic
Practice address
1201 Medical Plaza CT
Granbury, TX 76048-5684
Phone
(817) 279-9333
Fax
(817) 573-6234
NPI assigned
Jul 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Nicole Alison Mueller, DONPI 1992703789
Title
Owner
Phone
(817) 279-9333

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X TX Primary

Addresses

Primary practice location

1201 Medical Plaza CT
Granbury, TX 76048-5684

Mailing address

1201 Medical Plaza CT
Granbury, TX 76048-5684
Phone (817) 279-9333

Other identifiers 1

IdentifierTypeStateIssuer
163065901MedicaidTX

Other names 1

  • Granbury Eye Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040102000257 TX Part B Supplier - Clinic/Group Practice 4486553153 Receives reassigned benefits from 2 practitioners
Practice locations: Granbury, TX
O20100930023281 TX DME Supplier - Physician - Ophthalmology 4486553153 Practice locations: Granbury, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2177609Nicole a Mueller, PA1201 Medical Plaza Court, Granbury, TX 76048Certificate of waiverJan 14, 2028

National Provider Directory

National Provider Directory

Locations

1201 Medical Plaza Ct
Granbury, TX 76048
Phone (817) 279-9044

Practitioners & affiliated clinicians

Practitioners 3

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": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1861491037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 MEDICAL PLAZA CT",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485684",
            "telephone_number": "817-279-9333",
            "fax_number": "817-573-6234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 MEDICAL PLAZA CT",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485684",
            "telephone_number": "817-279-9333",
            "fax_number": "817-573-6234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE A. MUELLER P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MUELLER",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "ALISON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-279-9333",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163065901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granbury Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granbury, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.