Roanoke Family Eyecare

Primary specialty

OptometristTaxonomy code 152W00000X

License

5822-T Issued in TX

Legal business name

ROANOKE FAMILY EYECARE

Practice address

361 W Southlake Blvd Ste 100
Southlake, TX 76092-1481

Phone

(817) 491-4994

NPI assigned

Jan 28, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Nancy Davis, O.D.NPI 1558474726

Title

Ceo

Phone

(817) 491-4994

Specialties & licenses 1

Addresses

Other names 1

• Integrative Eyecare Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Nancy Davis, O.D.

  • Optometrist
  • Southlake, TX
  • NPI 1558474726
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1390867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701475200000",
    "number": "1952724924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 630917",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750630137",
            "telephone_number": "972-693-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 W SOUTHLAKE BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921481",
            "telephone_number": "817-491-4994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROANOKE FAMILY EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-28",
        "last_updated": "2023-12-02",
        "certification_date": "2023-12-02",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-491-4994",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5822-T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrative Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Abagail Rismiller
• Timothy E Ritter, M.D.
• Christine Ritualo, PT, DPT
• Allen Rivera, MA LPC
• Laura Anne Rizzo, MD
• Natalie A Roberge, M.D.
• Robert B. Guzman
• Robert N Freedenfeld, PHD, PC
• Robert Sewell, M.D., P.a.
• Mykin Roberts, MA, CCC/SLP

• Optometrist in Southlake, TX
• Providers in Southlake, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2023; 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.