Individual provider Active NPI

Ida R Reed, OD

  • Optometrist
  • Harlingen, TX
National Provider Identifier
1932284858
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5358T Issued in TX
Practice address
1205 N Ed Carey Drive
Harlingen, TX 78550-9207
Phone
(956) 423-2100
Fax
(956) 423-0180
NPI assigned
Oct 26, 2006
Last updated
Dec 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5358T TX Primary

Addresses

Primary practice location

1205 N Ed Carey Drive
Harlingen, TX 78550-9207

Mailing address

PO Box 531848
Harlingen, TX 78553-1848
Phone (956) 423-2100

Other identifiers 1

IdentifierTypeStateIssuer
0192304-02MedicaidTX

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
I20081004000032 TX Practitioner - Optometry 1951479997 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5358TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Eye Centers PA Optometrist CurrentSince Apr 16, 2018 Accepting new patients
Carlos Manrique de Lara Mdpa Optometrist CurrentSince Apr 22, 2017 Accepting new patients
South Texas Eye Centers PA PastSince Apr 16, 2018 Accepting new patients
William Justus Head MD PA PastSince Apr 22, 2017 Accepting new patients

Locations

847 Ridgewood St
Brownsville, TX 78520
Phone (956) 541-1013

2518 W Trenton Rd
Edinburg, TX 78539
Phone (956) 661-9000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1932284858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 531848",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785531848",
            "telephone_number": "956-423-2100",
            "fax_number": "956-682-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 N ED CAREY DRIVE",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785509207",
            "telephone_number": "956-423-2100",
            "fax_number": "956-423-0180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "IDA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5358T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0192304-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlingen, TX

Sources for this page

Verify at the official NPI Registry.