Brian K Shandley, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5022TG Issued in TX

Practice address

120 Highway 332 W
Ste A5
Lake Jackson, TX 77566-4020

Phone

(979) 297-8188

Fax

(979) 297-5410

NPI assigned

Jul 2, 2007

Last updated

Feb 19, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

University of Houston - College of Optometry, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brian K. Shandley OD PAGroup PAC ID 2668466475, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brian K. Shandley OD PA

  dba Texas State Optical

  • Optometrist
  • Lake Jackson, TX
  • NPI 1326262858
  Medicare reassignment Care Compare group NPD Authorized official
• Tso Bay City, PLLC

  • Optometrist
  • Bay City, TX
  • NPI 1215542022
  NPD (past)
• Tso Portland PLLC

  dba TSO Portland

  • Optometrist
  • Portland, TX
  • NPI 1245811850
  NPD (past)

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1912104969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HIGHWAY 332 W",
            "address_2": "STE A5",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775664020",
            "telephone_number": "979-297-8188",
            "fax_number": "979-297-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HIGHWAY 332 W",
            "address_2": "STE A5",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775664020",
            "telephone_number": "979-297-8188",
            "fax_number": "979-297-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANDLEY",
        "first_name": "BRIAN",
        "middle_name": "K",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5022TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "161005701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Ann Scott, COTA
• Sequin Homecare Services LLC
• Claudia Sereno
• Faith Serna, MS, RD, LD
• Mohiuddin Bilal Shamsi, DPM
• Darrin C. Shandley, OD
• Nicholas Shawver, LPC, LSOTP, LCDC-I
• Abdul Moid Shehzad, MD
• Loni Lynn Shepherd, MD
• Shepherds Pediatric Care

• Optometrist in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.