HENDERSON OPTICAL, LLC (NPI# 1083791354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083791354 |
| Entity Type | Organization |
| Organization Name | HENDERSON OPTICAL, LLC |
| Practice Address |
1201 Summit Ave Fort Worth TX 76102-4413 |
| Practice Telephone | 8173363653 |
| Practice Fax Number | 8173324233 |
| Mailing Telephone | 8173363653 |
| Mailing Fax Number | 8173324233 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-03-04 |
| Authorized Official Name | DAN BRUHL (OPHTHALMOLOGIST) |
| Authorized Official Telephone | 8173363653 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 019770901 | 05 |
| Street Address |
1201 SUMMIT AVE |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76102-4413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881690279 | Aziz Samir Abdul-rahim | Ophthalmology | 1201 Summit Ave, Fort Worth, TX 76102-4427 | 2005-06-22 |
| 1891313037 | Jordan L Haney | Nurse Practitioner | 1201 Summit Ave, Fort Worth, TX 76102-4413 | 2020-07-13 |
| 1487073953 | Derek Yang Han | Ophthalmology | 1201 Summit Ave, Fort Worth, TX 76102-4413 | 2014-04-14 |
| 1679991053 | Tina Chen | Ophthalmology | 1201 Summit Ave, Fort Worth, TX 76102-4413 | 2014-04-02 |
| 1942634662 | Harper Interventional Pain Center LLC | Clinic/Center | 1201 Summit Ave, Suite 400, Fort Worth, TX 76102-4413 | 2013-08-29 |
| 1356685861 | Marsh Interventional Pain Center, LLC | Clinic/Center | 1201 Summit Ave, Suite 400, Fort Worth, TX 76102-4413 | 2012-11-21 |
| 1265701767 | Judy Marie Myers | Optometrist | 1201 Summit Ave, Fort Worth, TX 76102-4413 | 2011-12-29 |
| 1124310073 | Penn Interventional Pain Center, LLC | Clinic/Center | 1201 Summit Ave, Suite 400, Fort Worth, TX 76102-4413 | 2011-05-11 |
| 1790089720 | Presidio Pain Center, LLC | Clinic/Center | 1201 Summit Ave, Suite 400, Fort Worth, TX 76102-4413 | 2011-01-05 |
| 1295045854 | Summit Avenue Pain Center, LLC | Clinic/Center | 1201 Summit Ave, Suite 400, Fort Worth, TX 76102-4413 | 2010-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285113746 | Deirdre P Browne | Counselor | 1500 E El Paso, Fort Worth, TX 76102 | 2018-08-07 |
| 1740784206 | Cvs Pharmacy Inc | Pharmacy | 515 Houston St, Fort Worth, TX 76102 | 2018-03-20 |
| 1316448061 | Diondra Deshawn Narcisse | Licensed Vocational Nurse | 1314 Lake Street, Fort Worth, TX 76102 | 2018-02-27 |
| 1649779943 | Carmela A Solis | Specialist/Technologist, Other | 500 Throckmorton Street Unit 3309, Fort Worth, TX 76102 | 2018-02-02 |
| 1104324516 | Vicki Webb-baker | Health Educator | 512 Lamar Street, Suite 400, Fort Worth, TX 76102 | 2018-01-31 |
| 1235647678 | Brianna Marie Keister | Occupational Therapist | 201 W. Lancaster Ave, 417, Fort Worth, TX 76102 | 2018-01-19 |
| 1437507910 | Medical Hearing Services, LLC | Hearing Aid Equipment | 1201 Summit Avenue, Fort Worth, TX 76102 | 2016-05-25 |
| 1891171476 | Karis Starke | Physical Therapy Assistant | 2500 West Freeway (i-30), 100, Fort Worth, TX 76102 | 2015-08-05 |
| 1265839344 | Fm Katy Dental and Orthodontics, Pllc | Dentist | 100 E 15th Ste 520, Fort Worth, TX 76102 | 2014-12-04 |
| 1093134512 | Superior Evaluation Services | General Practice | 420 Throckmorton Suite 200, Ft. Worth, TX 76102 | 2014-04-11 |
| Find all providers in zip 76102 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124504063 | National Vision Inc | Technician/Technologist | 2600 W 7th St Ste 145, Fort Worth, TX 76107-9301 | 2018-07-13 |
| 1366935165 | National Vision, Inc. | Technician/Technologist | 2644 East Berry Street, Fort Worth, TX 76105 | 2018-06-07 |
| 1447636600 | Zaheer Habibi | Technician/Technologist | 2536 Mall Cir, Suite D, Fort Worth, TX 76116-1545 | 2015-08-10 |
| 1902203805 | National Vision, Inc. | Technician/Technologist | 4811 Overton Ridge Blvd, Ste 228, Fort Worth, TX 76132-1972 | 2014-11-21 |
| 1851716625 | America's Best Contacts & Eyeglasses | Technician/Technologist | 3016 Texas Sage Trl, Fort Worth, TX 76177-8589 | 2014-03-03 |
| 1972943355 | Wal-mart Stores Texas, LLC | Technician/Technologist | 2401 Avondale Haslet, Fort Worth, TX 76052 | 2013-06-28 |
| 1285978692 | Wal-mart Stores Texas LLC | Technician/Technologist | 2900 Renaissance Square, Fort Worth, TX 76105 | 2012-11-26 |
| 1558636324 | Christina Wolinski | Technician/Technologist | 3789 N Beach St, Suite 213, Fort Worth, TX 76137-3244 | 2012-03-13 |
| 1225205602 | Willie Jake Wright II | Technician/Technologist | 5862 S Hulen St, Fort Worth, TX 76132-2684 | 2008-05-14 |
| 1013050319 | Janice Kay Faulkner | Technician/Technologist | 1223 5th Ave, Fort Worth, TX 76104 | 2007-02-15 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76102 |
Please comment or provide details below to improve the information on HENDERSON OPTICAL, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.