SPECIALEYES OPTICAL, LLC (NPI# 1124573092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124573092 |
| Entity Type | Organization |
| Organization Name | SPECIALEYES OPTICAL, LLC |
| Practice Address |
1106 Alexis Ct Mansfield TX 76063-3338 |
| Mailing Address |
321 S Henderson St Fort Worth TX 76104-1016 |
| Practice Telephone | 8175299929 |
| Practice Fax Number | 8175299927 |
| Mailing Telephone | 8175299929 |
| Mailing Fax Number | 8175299927 |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2016-08-22 |
| Authorized Official Name | DR. ERIC ALAN PACKWOOD (MEMBER) |
| Authorized Official Telephone | 8175299949 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 7210TG | TX | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 287401803 | 05 | |
| TX | 207716601 | 05 | |
| TX | 294486001 | 05 | |
| TX | 323588905 | 05 | |
| TX | 018440004 | 05 | |
| TX | 145291402 | 05 | |
| TX | 166926901 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821564964 | Specialeyes Optical, LLC | Optometrist | 2212 Emery St, Denton, TX 76201-1100 | 2018-10-16 |
| 1679028542 | Specialeyes Optical, LLC | Optometrist | 105 River Oakes Dr., Southlake, TX 76092 | 2016-08-22 |
| 1891150058 | Specialeyes Optical, LLC | Optometrist | 321 S Henderson St, Fort Worth, TX 76104-1016 | 2015-12-15 |
| Street Address |
1106 ALEXIS CT |
| City | MANSFIELD |
| State | TX |
| Zip Code | 76063-3338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316558349 | Lindsey Vandyke, D.o. Pllc | Internal Medicine | 3150 E Broad Street, Ste 100, Mansfield, TX 76063 | 2020-08-13 |
| 1942819867 | Jennifer Que Chau Nguyen | Pharmacist | 980 U.S. 287 Frontage Rd #287, Mansfield, TX 76063 | 2020-07-27 |
| 1194346890 | Ana Maria Gonzalez | Dentist | 1600 Us Highway 287, Suite 102, Mansfield, TX 76063 | 2020-05-04 |
| 1245869080 | Stateserv Medical of Texas, LLC | Durable Medical Equipment & Medical Supplies | 7941 Rodeo Trail, Mansfield, TX 76063 | 2020-04-03 |
| 1649802232 | Mary Puanani Kamai | Nurse Practitioner | 1301 E. Debbie Lane, Suite 102 #1405, Mansfield, TX 76063 | 2020-02-11 |
| 1770123028 | Gladys Vera Nfodzo | Nurse Practitioner | 901 W. Broad St, Mansfield, TX 76063 | 2020-01-14 |
| 1669011300 | Alexa Smith | Nurse Practitioner | 2800 E Broad St #304, Mansfield, TX 76063 | 2019-12-28 |
| 1477190437 | Mel Rockwall LLC | Optometrist | 1701 East Broad Street, Ste 109, Mansfield, TX 76063 | 2019-12-09 |
| 1376185512 | Daniel Max & Marcandrea LLC | Optometrist | 1701 East Broad St., Ste 109, Mansfield, TX 76063 | 2019-10-09 |
| 1861046385 | Lacey Eaton | Counselor | 805 Killian Dr, Mansfield, TX 76063 | 2019-08-01 |
| Find all providers in zip 76063 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477190437 | Mel Rockwall LLC | Optometrist | 1701 East Broad Street, Ste 109, Mansfield, TX 76063 | 2019-12-09 |
| 1376185512 | Daniel Max & Marcandrea LLC | Optometrist | 1701 East Broad St., Ste 109, Mansfield, TX 76063 | 2019-10-09 |
| 1932753027 | Phuong Pham | Optometrist | 1971 U.S. 287 Frontage Rd Ste 105, Mansfield, Tx 76063, Mansfield, TX 76063-7606 | 2019-07-28 |
| 1174175855 | Sabrina Gaan Od LLC | Optometrist | 287 School St Ste 140, Mansfield, MA 02048-1850 | 2019-07-12 |
| 1831667906 | Boyd Eye Care LLC | Optometrist | 1560 Highway 287 N Ste 300, Mansfield, TX 76063-8824 | 2018-11-07 |
| 1992271480 | Colston Eye Care, Pllc | Optometrist | 3150 E Broad St, Ste 120, Mansfield, TX 76063 | 2018-10-23 |
| 1083135404 | Benjamin Dean Colston | Optometrist | 3150 East Broad Street, Suite 120, Mansfield, TX 76063 | 2017-07-06 |
| 1982125316 | Lily Vision Pllc | Optometrist | 1971 Highway 287 N Ste 104, Mansfield, TX 76063-8982 | 2017-07-06 |
| 1427420702 | Schluterman Eye Care & Optical, Inc | Optometrist | 100 N Walnut Ave, Suite C, Mansfield, AR 72944-3522 | 2015-10-26 |
| 1700268448 | Johnny Phan | Optometrist | 990 U.S. 287 Frontage Rd, #109, Mansfield, TX 76063 | 2015-06-18 |
| Find all providers in MANSFIELD | ||||
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| 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.