Individual provider Active NPI

Emery C. Huber, O.D

  • Optometrist
  • Grand Prairie, TX
National Provider Identifier
1912911504
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2519 TG Issued in TX
Practice address
2080 North Highway 360 #125
Grand Prairie, TX 75050-1400
Phone
(817) 633-2020
Fax
(214) 788-2373
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2519 TG TX Primary

Addresses

Primary practice location

2080 North Highway 360 #125
Grand Prairie, TX 75050-1400

Mailing address

2080 North Highway 360
Ste:125
Grand Prairie, TX 75050-1400
Phone (817) 633-2020

Other identifiers 2

IdentifierTypeStateIssuer
75-1822552OtherTXTAX ID
DR3272OtherTXGROUP PTAN -RAILROAD RETIREMENT

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
I20040427000698 TX Practitioner - Optometry 6204823834 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2519 TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ahl Eyecare PLLC Optometrist CurrentSince Dec 9, 2022 Accepting new patients
Texas Eye Physicians PA PastSince Jul 12, 2002 Accepting new patients
Renaissance Eyecare Past Accepting new patients

Locations

2080 N State Highway 360
Ste 270
Grand Prairie, TX 75050
Phone (817) 633-2020

Organizations & group practices 3

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1912911504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 NORTH HIGHWAY 360",
            "address_2": "STE:125",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750501400",
            "telephone_number": "817-633-2020",
            "fax_number": "214-788-2373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 NORTH HIGHWAY 360 #125",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750501400",
            "telephone_number": "817-633-2020",
            "fax_number": "214-788-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBER",
        "first_name": "EMERY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2519 TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "75-1822552",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN -RAILROAD RETIREMENT",
            "identifier": "DR3272",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.