Organization Active NPI

Elite Vision Center

  • Optometrist
  • Arlington, TX
National Provider Identifier
1972149714
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ELITE VISION CENTER
Practice address
5335 W Sublett Rd Ste 131
Arlington, TX 76017-1184
Phone
(817) 200-3939
NPI assigned
Nov 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Authorized official

Name
Dr. Gloria L Hentz, ODNPI 1174835276
Title
Optometrist
Phone
(817) 200-3939

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

5335 W Sublett Rd Ste 131
Arlington, TX 76017-1184

Mailing address

PO Box 8095
Fort Worth, TX 76124-0095

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200608001616 TX Part B Supplier - Clinic/Group Practice 6608297296 Receives reassigned benefits from 2 practitioners
Practice locations: Arlington, TX

National Provider Directory

National Provider Directory

Locations

5335 W Sublett Rd
Ste 600
Arlington, TX 76017

5335 W Sublett Rd
Ste 131
Arlington, TX 76017
Phone (817) 200-3939

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619136000000",
    "number": "1972149714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8095",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761240095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5335 W SUBLETT RD STE 131",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760171184",
            "telephone_number": "817-200-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE VISION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-26",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A",
        "authorized_official_last_name": "HENTZ",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "817-200-3939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "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 Apr 23, 2021; 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.