Active NPI
Stephanie Yachen Chen, O.D.
- Optometrist
- Farmers Branch, TX
National Provider Identifier
1922112507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 6065
- Practice address
- 4122 L B J Fwy Ste 120
Farmers Branch, TX 75244-5703 - Phone
- (972) 392-0884
- Fax
- (972) 392-0884
- NPI assigned
- Aug 19, 2006
- Last updated
- Nov 4, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 6065 | TX | Primary |
| Corneal and Contact Management Optometrist | 152WC0802X | 6065T | TX |
Addresses
Primary practice location
4122 L B J Fwy Ste 120
Farmers Branch, TX 75244-5703
Mailing address
7004 Chandler Dr
Plano, TX 75024-4807
Phone (469) 688-0399
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8F4937 | Other | TX | MEDICARE PTAN |
| 3795528 | Medicaid | TX |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | info@eagleeyepa.com |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6065T | TX | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eagle Eye Associates, P.a | Corneal and Contact Management | Current | Accepting new patients |
Locations
13307 Midway Rd
Ste 100
Farmers Branch, TX 75244
Phone (972) 392-0884
4122 LBJ
Ste 120
Farmers Branch, TX 75244
Phone (972) 392-0884
Organizations & group practices 1
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.
-
- Corneal and Contact Management Optometrist
- Farmers Branch, TX
- NPI 1962626259
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572825600000",
"number": "1922112507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7004 CHANDLER DR",
"city": "PLANO",
"state": "TX",
"postal_code": "750244807",
"telephone_number": "469-688-0399",
"fax_number": "972-392-0884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4122 L B J FWY STE 120",
"city": "FARMERS BRANCH",
"state": "TX",
"postal_code": "752445703",
"telephone_number": "972-392-0884",
"fax_number": "972-392-0884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEN",
"first_name": "STEPHANIE YACHEN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2019-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "6065",
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "TX",
"license": "6065T",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "8F4937",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3795528",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "info@eagleeyepa.com",
"affiliation": "N",
"address_1": "4122 L B J Fwy Ste 120",
"city": "Farmers Branch",
"state": "TX",
"country_code": "US",
"postal_code": "752445703",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Farmers Branch, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.