Individual provider Active NPI

Jeffrey Nelson Legrande, O.D.

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1972594927
Registry record updated Apr 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6528T Issued in TX
Practice address
8202 N Loop 1604 W Ste 105
San Antonio, TX 78249-2898
Phone
(210) 691-4733
Fax
(210) 424-9156
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6528T TX Primary

Addresses

Primary practice location

8202 N Loop 1604 W Ste 105
San Antonio, TX 78249-2898

Mailing address

8202 N Loop 1604 W
Ste 105
San Antonio, TX 78249-2897
Phone (210) 691-4733

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
6528TTXMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396656000000",
    "number": "1972594927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8202 N LOOP 1604 W",
            "address_2": "STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492897",
            "telephone_number": "210-691-4733",
            "fax_number": "210-691-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8202 N LOOP 1604 W STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492898",
            "telephone_number": "210-691-4733",
            "fax_number": "210-424-9156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGRANDE",
        "first_name": "JEFFREY",
        "middle_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2014-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6528T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2014; 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.