Marlan G Anderson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3004TG Issued in TX

Practice address

15677 San Pedro Ave
B
San Antonio, TX 78232-3732

Phone

(210) 490-9205

Fax

(210) 490-3633

NPI assigned

Jun 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aeg Texas Professional PLLC

  • Optometrist
  • Kerrville, TX
  • NPI 1457905937
  Medicare reassignment Care Compare group NPD
• DRS. Bell, Davis, Elder & Assoc

  • Optometrist
  • San Antonio, TX
  • NPI 1982731287
  NPD (past)
• Janet B Ogletree OD PA

  • Optometrist
  • Flower Mound, TX
  • NPI 1740313089
  NPD (past)

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1871533745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160308",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782802508",
            "telephone_number": "210-366-1199",
            "fax_number": "210-349-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15677 SAN PEDRO AVE",
            "address_2": "B",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782323732",
            "telephone_number": "210-490-9205",
            "fax_number": "210-490-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MARLAN",
        "middle_name": "G",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3004TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112381203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kent Lowell Anderson, M.D., PH.D.
• Kino Ijabalani Anderson
• Lacey Dawn Anderson, LPC
• Lauren Elizabeth Anderson, SLP
• Lisa Anderson, DNP, APRN, PMHNP-BC
• Marshall David Anderson, DC
• Michael Anderson
• Michael Anderson, DO
• Michelle Ann Anderson, LMT
• Nikki Anderson

• Optometrist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.