SAM'S CLUB OPTICAL (NPI# 1174610752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174610752 |
Entity Type | Organization |
Organization Name | SAM'S CLUB OPTICAL |
Other Organization Name | SAM'S CLUB OPTICAL 30-8284 |
Practice Address |
2025 S Southwest Loop 323 Tyler TX 75701-0763 |
Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
Practice Telephone | 9035972296 |
Enumeration Date | 2006-10-06 |
Last Update Date | 2020-08-22 |
Authorized Official Name | LINDA M. EPPERSON (NPI COORDINATOR) |
Authorized Official Telephone | 3167885580 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers | ||
X | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
Other Name | Type Code |
---|---|
Sam's Club Optical 30-8284 | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881924413 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 4420 King Avenue East, Billings, MT 59101 | 2010-01-04 |
1457589111 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 450 Townsend Road, Cocoa, FL 32926 | 2009-07-01 |
1427286251 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 745 W El Camino Alto Drive, Springfield (s), MO 65810 | 2009-07-01 |
1093951956 | Sam's Club Optical | Technician/Technologist | 755 N. Hwy 27/441, Lady Lake (the Villages), FL 32159 | 2008-12-24 |
1619125903 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 3247 23rd Avenue, Evans, CO 80620 | 2008-08-29 |
1720236011 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 2000 Clements Bridge Rd Ste 116, Deptford, NJ 08096-2011 | 2008-08-29 |
1184886913 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 11278 South Jordan Gtwy, South Jordan, UT 84095 | 2008-07-02 |
1356516116 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 3839 Mundy Mill Road, Oakwood, GA 30566 | 2008-04-23 |
1104095801 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 7100 West Arroyo Crossing Pkwy, Las Vegas, NV 89113 | 2008-02-27 |
1114101193 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 2650 East Craig Road, North Las Vegas, NV 89030 | 2007-12-26 |
Street Address |
2025 S SOUTHWEST LOOP 323 |
City | TYLER |
State | TX |
Zip Code | 75701-0763 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841217981 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 2025 S Southwest Loop 323, Tyler, TX 75701-0763 | 2006-07-16 |
1568063147 | Shad Moon | Pharmacist | 2025 S Southwest Loop 323, Tyler, TX 75701-0763 | 2020-11-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
Find all providers in zip 75701 |
Taxonomy Code | 156FX1800X |
Grouping | Eye and Vision Services Providers |
Classification | Technician/Technologist |
Specialization | Optician |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952750325 | National Vision, Inc. | Technician/Technologist | 6710 S Broadway Ave, Ste100, Tyler, TX 75703-4755 | 2016-06-07 |
1912088352 | Wal-mart Stores Texas, LLC | Technician/Technologist | 3820 Highway 64 W, Tyler, TX 75704-6924 | 2006-10-18 |
1972041374 | Wal-mart Stores Texas, LLC | Technician/Technologist | 450 S Southeast Loop 323, Tyler, TX 75702-8646 | 2017-02-06 |
1508153347 | Eyeglass World | Technician/Technologist | 4901 S Broadway Ave, Tyler, TX 75703-1325 | 2011-06-30 |
1467533810 | Wal-mart Stores Texas, Lp | Technician/Technologist | 6801 S Broadway Ave, Tyler, TX 75703-4733 | 2006-10-18 |
1912004375 | Wal-mart Stores Texas, LLC | Technician/Technologist | 5050 Troup Hwy, Tyler, TX 75707-1916 | 2006-09-20 |
1912923590 | East Texas Eye Care Associates LLC | Technician/Technologist | 2440 E 5th St, Tyler, TX 75701-3525 | 2006-07-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568095271 | Quyen Ngo Nguyen | Technician/Technologist | 1830 S Mason Rd Ste 125, Katy, TX 77450-3240 | 2020-02-20 |
1710522479 | Mikel Rivera | Technician/Technologist | 314 N Walnut St Ste C, Sherman, TX 75090-0047 | 2019-11-16 |
1740822501 | Eyeglasses of Texas | Technician/Technologist | 6200 Bellaire Blvd Ste J, Houston, TX 77081-4902 | 2019-10-14 |
1013558840 | Cristian Villagomez | Technician/Technologist | 2128 Kazmeier Plz, Bryan, TX 77802-3414 | 2019-10-02 |
1104393339 | National Vision Inc | Technician/Technologist | 2525 W Anderson Ln Ste 150, Austin, TX 78757-1180 | 2018-10-25 |
1063987618 | Stephen Williams | Technician/Technologist | 701 Commerce St Ste 629, Dallas, TX 75202-4522 | 2018-10-10 |
1174007207 | National Vision Inc | Technician/Technologist | 3916 Kemp Blvd Ste K, Wichita Falls, TX 76308-2119 | 2018-09-25 |
1295217032 | Richard D Reyes | Technician/Technologist | 115 E Travis St Ste 100, San Antonio, TX 78205-1668 | 2018-08-29 |
1205316890 | Katherine Denney | Technician/Technologist | 202 W Main St Ste 200-107, Allen, TX 75013-8094 | 2018-08-14 |
1407332497 | National Vision Inc | Technician/Technologist | 3649 Catclaw Dr, Abilene, TX 79606-8249 | 2018-07-13 |
Find all providers with the same taxonomy |
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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.