Park Forest Optical LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PARK FOREST OPTICAL LLC

Practice address

11722 Marsh LN Ste 350
Dallas, TX 75229-2683

Phone

(214) 902-9779

Fax

(214) 902-8810

NPI assigned

Dec 17, 2020

Organization subpart

No

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

Authorized official

Name

Lance Chong, ODNPI 1821190141

Title

Owner

Phone

(214) 924-3341

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

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

• Lance M Chong, O.D.

  • Optometrist
  • Garland, TX
  • NPI 1821190141
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1982290649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11722 MARSH LN STE 350",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752292683",
            "telephone_number": "214-902-9779",
            "fax_number": "214-902-8810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11722 MARSH LN STE 350",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752292683",
            "telephone_number": "214-902-9779",
            "fax_number": "214-902-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK FOREST OPTICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A",
        "authorized_official_last_name": "CHONG",
        "authorized_official_first_name": "LANCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-924-3341",
        "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": []
}

• Park Cities Sleep Center, LLP
• Park Cities Speech, Language & Learning
• Park Cities Weightloss Clinic, LLC (Medi-Weightloss Clinics)
• Park Cities Wellness Plus LLC
• Park Forest Eye Care, PLLC (First Eye Care Park Forest)
• Park Infusioncare LP
• Park Infusioncare, LP
• Park Lane Allergy and Asthma Center, PA
• Park Lane Medical Group P.a.
• Park Lane Surgery Center

• Optometrist in Dallas, TX
• Providers in Dallas, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; 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.