NPIMap

Organization Active NPI

2020 Eyedr

Doing business as Southlake Eyes Now

  • Optometrist
  • Southlake, TX
National Provider Identifier
1942754700
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8563 Issued in TX
Legal business name
2020 EYEDR
Doing business as
Southlake Eyes Now
Practice address
1251 E Southlake Blvd
Suite 331
Southlake, TX 76092-6478
Phone
(630) 452-6290
Fax
(888) 619-2009
NPI assigned
Aug 10, 2016
Last updated
Aug 10, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Authorized official

Name
Dr. Manoj Abraham, ODNPI 1952500159
Title
Optometrist
Phone
(630) 452-6290

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8563 TX Primary

Addresses

Primary practice location

1251 E Southlake Blvd
Suite 331
Southlake, TX 76092-6478

Mailing address

1505 Stone Dr
Carrollton, TX 75010-1147
Phone (630) 452-6290

Other names 1

  • Southlake Eyes Now Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161013001700 TX Part B Supplier - Clinic/Group Practice 9537457189 Receives reassigned benefits from 17 practitioners
Practice locations: Dallas, TX; Southlake, TX; Irving, TX; Hurst, TX

National Provider Directory

National Provider Directory

Locations

2401 S Stemmons Fwy
Ste 2000
Lewisville, TX 75067
Phone (972) 315-0111

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470787200000",
    "number": "1942754700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 STONE DR",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750101147",
            "telephone_number": "630-452-6290",
            "fax_number": "888-619-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 E SOUTHLAKE BLVD",
            "address_2": "SUITE 331",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926478",
            "telephone_number": "630-452-6290",
            "fax_number": "888-619-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2020 EYEDR",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-10",
        "last_updated": "2016-08-10",
        "status": "A",
        "authorized_official_last_name": "ABRAHAM",
        "authorized_official_first_name": "MANOJ",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "630-452-6290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southlake Eyes Now",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.