Specialeyes Optical, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

7210TG Issued in TX

Legal business name

SPECIALEYES OPTICAL, LLC

Practice address

321 S Henderson St
Fort Worth, TX 76104-1016

Phone

(817) 529-9929

Fax

(817) 529-9927

NPI assigned

Dec 15, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Eric Alan Packwood, MD

Title

Member

Phone

(817) 529-9929

Specialties & licenses 1

Addresses

Other identifiers 7

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alan Andrew Norman, MD

  • Ophthalmology Physician
  • Fort Worth, TX
  • NPI 1346219821
  NPD (past)

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450137600000",
    "number": "1891150058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 S HENDERSON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761041016",
            "telephone_number": "817-529-9929",
            "fax_number": "817-529-9927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 S HENDERSON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761041016",
            "telephone_number": "817-529-9929",
            "fax_number": "817-529-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALEYES OPTICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-15",
        "last_updated": "2015-12-15",
        "status": "A",
        "authorized_official_last_name": "PACKWOOD",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "817-529-9929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7210TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145291402",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287401802",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "294486001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018440004",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207716601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166926901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "323588905",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Speaker, M.D.
• Lynn Marie Speaks, D.O.
• Brent Allen Spear, DDS
• Dave S Spear, MD
• Joann Marie Spears, RN
• Spectrum Monitoring PLLC
• Spectrum Support Center, LLC
• Speech Divas
• Speech Up
• Hannah Speight

• Optometrist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.