NPIMap

Organization Active NPI

Advanced Visioncare of Desoto PA

  • Optometrist
  • Desoto, TX
National Provider Identifier
1962702654
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4711T Issued in TX
Legal business name
ADVANCED VISIONCARE OF DESOTO PA
Practice address
600 N Hampton Rd
Desoto, TX 75115-4508
Phone
(972) 223-5354
Fax
(972) 274-0607
NPI assigned
Oct 27, 2010
Last updated
Oct 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Authorized official

Name
James Kevin SmithNPI 1710040571
Title
Manager
Phone
(972) 223-5354

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4711T TX Primary

Addresses

Primary practice location

600 N Hampton Rd
Desoto, TX 75115-4508

Mailing address

600 N Hampton Rd
Desoto, TX 75115-4508
Phone (972) 223-5354

National Provider Directory

National Provider Directory

Locations

600 N Hampton Rd
Desoto, TX 75115
Phone (972) 223-5354

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1962702654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N HAMPTON RD",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154508",
            "telephone_number": "972-223-5354",
            "fax_number": "972-274-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N HAMPTON RD",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154508",
            "telephone_number": "972-223-5354",
            "fax_number": "972-274-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED VISIONCARE OF DESOTO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-27",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "972-223-5354"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4711T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; 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.