Individual provider Active NPI

Mark Robert Hanson, OD

  • Optometrist
  • Arlington, TX
National Provider Identifier
1962402412
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3043TG Issued in TX
Practice address
2351 W Lamar Blvd
Arlington, TX 76012-5669
Phone
(817) 861-2020
NPI assigned
Jul 27, 2005
Reactivated
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3043TG TX Primary

Addresses

Primary practice location

2351 W Lamar Blvd
Arlington, TX 76012-5669

Mailing address

2351 W Lamar Blvd
Arlington, TX 76012-5669
Phone (817) 861-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3043TGTXMDOptometrist
3043TXMDSports Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Huynh and Associates LLC Optometrist CurrentSince Aug 2, 2020 Accepting new patients

Locations

2351 W Lamar Blvd
Arlington, TX 76012
Phone (817) 861-2020

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197590400000",
    "number": "1962402412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 W LAMAR BLVD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760125669",
            "telephone_number": "817-861-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 W LAMAR BLVD",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760125669",
            "telephone_number": "817-861-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "MARK",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-27",
        "last_updated": "2007-12-14",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3043TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; 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.