Individual provider Active NPI

Clive J Thomson, OD

  • Optometrist
  • Brownsville, TX
National Provider Identifier
1962567487
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6663T Issued in TX
Practice address
3147 Boca Chica Blvd
Brownsville, TX 78521-3567
Phone
(956) 544-2607
Fax
(956) 544-2608
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2219 TN
Optometrist 152W00000X 6663T TX Primary

Addresses

Primary practice location

3147 Boca Chica Blvd
Brownsville, TX 78521-3567

Mailing address

1804 S 10TH St
McAllen, TX 78503-5402
Phone (956) 687-2875

Other identifiers 2

IdentifierTypeStateIssuer
8F21175OtherTXMEDICARE
3944381MedicaidTN

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sights My Line, Inc Past Accepting new patients
Tham Nguyen, O.D.P.a Optometrist Past Accepting new patients
Amedco Texas LLC Optometrist Past Accepting new patients
Primary Care Ophthalmology, Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1962567487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 S 10TH ST",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785035402",
            "telephone_number": "956-687-2875",
            "fax_number": "956-687-3128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3147 BOCA CHICA BLVD",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785213567",
            "telephone_number": "956-544-2607",
            "fax_number": "956-544-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "CLIVE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2219",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6663T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "8F21175",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3944381",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.