De Soto Eye Care LLC

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

Organization subpart

No

Name

Dr. Douglas J MC Guire Jr., OD

Title

Optometrist

Phone

(636) 586-5406

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles William Pelton, O.D.

  • Optometrist
  • De Soto, MO
  • NPI 1962767665
  NPD
• Gennadiy Dameshek, O.D.

  • Optometrist
  • De Soto, MO
  • NPI 1871799106
  NPD (past)
• Sara M Pyatt, O.D.

  • Optometrist
  • Potosi, MO
  • NPI 1942462965
  NPD (past)

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 15, 2009.

{
    "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "315698803",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "313299505",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Ann Cooper, PTA
• Steven Crawford, DO
• Patricia Ann Culbertson, MA, LPC
• Gennadiy Dameshek, O.D.
• De Soto Drug Co Inc
• De Soto Public Schools
• Hattie Debord, FNP
• Desoto Chiropractic, P.C.
• Desoto Investment Group LLC
• Desoto Investment Group LLC

• All providers in De Soto, MO
• Optometrist in Missouri

• 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.