Organization Active NPI

Grace Eye Clinic PA

  • Optometrist
  • Dallas, TX
National Provider Identifier
1992903900
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
07005TG Issued in TX
Legal business name
GRACE EYE CLINIC PA
Practice address
13331 Preston Rd
1068
Dallas, TX 75240-1130
Phone
(972) 458-7979
Fax
(972) 458-7503
NPI assigned
Jul 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Authorized official

Name
Dr. Youngson Joe, OD
Title
President
Phone
(972) 458-7979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 07005TG TX Primary

Addresses

Primary practice location

13331 Preston Rd
1068
Dallas, TX 75240-1130

Mailing address

13331 Preston Rd
1068
Dallas, TX 75240-1130
Phone (972) 458-7979

Other names 1

  • BRAZOS EYE CARE Doing business as

National Provider Directory

National Provider Directory

Locations

13331 Preston Rd
#1068
Dallas, TX 75240
Phone (972) 458-7979

Practitioners & affiliated clinicians

Practitioners 1

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": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1992903900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13331 PRESTON RD",
            "address_2": "1068",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752401130",
            "telephone_number": "972-458-7979",
            "fax_number": "972-458-7503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13331 PRESTON RD",
            "address_2": "1068",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752401130",
            "telephone_number": "972-458-7979",
            "fax_number": "972-458-7503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE EYE CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "JOE",
        "authorized_official_first_name": "YOUNGSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-458-7979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "07005TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRAZOS EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.