Individual provider Active NPI

Sally Mina, O. D.

  • Optometrist
  • Plano, TX
National Provider Identifier
1902184633
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8802TG Issued in TX
Practice address
8621 Ohio Dr Ste 100
Plano, TX 75024-2264
Phone
(469) 656-8361
Fax
(972) 521-6109
NPI assigned
Jul 29, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2254 MD
Optometrist 152W00000X 8802TG TX Primary

Addresses

Primary practice location

8621 Ohio Dr Ste 100
Plano, TX 75024-2264

Mailing address

8621 Ohio Dr Ste 100
Plano, TX 75024-2264
Phone (469) 656-8361

Other identifiers 2

IdentifierTypeStateIssuer
8802TGOtherTXTEXAS BOARD OF OPTOMETRY
TA2254OtherMDMARYLAND LICENSE NUMBER

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
I20190516002717 TX Practitioner - Optometry 9830369008 Reassigns benefits to 2 organizations
Practice locations: Plano, TX

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8621 Ohio Dr
Suite 100
Plano, TX 75024-2264
Phone (469) 656-8361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8802TXMDChiropractor
TA2254MDMDOptometrist
8802TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Motiveyes Eye Care PLLC Optometrist CurrentSince Jun 8, 2022 Accepting new patients

Locations

1700 Dallas Pkwy
Ste 100
Plano, TX 75093
Phone (469) 656-8361

8621 Ohio Dr
Ste 100
Plano, TX 75024
Phone (469) 656-8361

Organizations & group practices 2

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": "1311897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1902184633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8621 OHIO DR STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242264",
            "telephone_number": "469-656-8361",
            "fax_number": "972-521-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8621 OHIO DR STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750242264",
            "telephone_number": "469-656-8361",
            "fax_number": "972-521-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINA",
        "first_name": "SALLY",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-29",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2254",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8802TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF OPTOMETRY",
            "identifier": "8802TG",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND LICENSE NUMBER",
            "identifier": "TA2254",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.