Active NPI
Richard Pharus Jackson, O.D.
- Optometrist
- Anthony, TX
National Provider Identifier
1972616134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4023T
- Practice address
- 216 W Washington St
Anthony, TX 79821-9304 - Phone
- (915) 886-3005
- Fax
- (915) 886-3005
- NPI assigned
- Aug 15, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4023T | TX | Primary |
Addresses
Primary practice location
216 W Washington St
Anthony, TX 79821-9304
Mailing address
216 W Washington St
Anthony, TX 79821-9304
Phone (915) 886-3005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100617000325 | TX | Practitioner - Optometry | 8426188459 | Practice locations: Anthony, TX; Socorro, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4023T | TX | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972616134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "216 W WASHINGTON ST",
"city": "ANTHONY",
"state": "TX",
"postal_code": "798219304",
"telephone_number": "915-886-3005",
"fax_number": "915-886-3005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "216 W WASHINGTON ST",
"city": "ANTHONY",
"state": "TX",
"postal_code": "798219304",
"telephone_number": "915-886-3005",
"fax_number": "915-886-3005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "RICHARD",
"middle_name": "PHARUS",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "4023T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anthony, TX
- Karla Adriana Cuaron, PHARMD
- Jose Humberto Enriquez Sr., ACNP-BC
- Daneida Ferreira
- Moises Gotbeter, D.D.S.
- Beatriz Ibarra
- Jasvinder Badwalz DMD PLLC (Anthony Dental)
- Joseph Anderson Kincaid Jr., DVM, ND
- Kirk a. Chandler, DO PA (Chandler Family Health)
- Andre Gilberto Montes, R.PH. , PHARM. D
- Celeste Rodriguez
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.