NPIMap

Organization Active NPI

De Soto Eye Care LLC

  • Optometrist
  • De Soto, MO
National Provider Identifier
1922268564
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T03075 Issued in MO
Legal business name
DE SOTO EYE CARE LLC
Practice address
126 S Main St
De Soto, MO 63020-2104
Phone
(636) 586-5406
Fax
(636) 586-1969
NPI assigned
Jun 16, 2008
Last updated
Jul 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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

Authorized official

Name
Dr. Douglas J MC Guire Jr., OD
Title
Optometrist
Phone
(636) 586-5406

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X T03075 MO Primary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X T02872 MO

Addresses

Primary practice location

126 S Main St
De Soto, MO 63020-2104

Mailing address

126 S Main St
De Soto, MO 63020-2104
Phone (636) 586-5406

National Provider Directory

National Provider Directory

Locations

126 S Main St
De Soto, MO 63020
Phone (636) 586-5406

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247616000000",
    "number": "1922268564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 S MAIN ST",
            "city": "DE SOTO",
            "state": "MO",
            "postal_code": "630202104",
            "telephone_number": "636-586-5406",
            "fax_number": "636-586-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 S MAIN ST",
            "city": "DE SOTO",
            "state": "MO",
            "postal_code": "630202104",
            "telephone_number": "636-586-5406",
            "fax_number": "636-586-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DE SOTO EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2009-07-15",
        "status": "A",
        "authorized_official_last_name": "MC GUIRE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "636-586-5406",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03075",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02872",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in De Soto, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; 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.