SPECIALEYES OPTICAL, LLC (NPI# 1891150058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891150058 |
| Entity Type | Organization |
| Organization Name | SPECIALEYES OPTICAL, LLC |
| Practice 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 | 2015-12-15 |
| Last Update Date | 2015-12-15 |
| Authorized Official Name | DR. ERIC ALAN PACKWOOD (MEMBER) |
| Authorized Official Telephone | 8175299929 |
| 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 | 294486001 | 05 | |
| TX | 018440004 | 05 | |
| TX | 145291402 | 05 | |
| TX | 323588905 | 05 | |
| TX | 287401802 | 05 | |
| TX | 166926901 | 05 | |
| TX | 207716601 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821564964 | Specialeyes Optical, LLC | Optometrist | 2212 Emery St, Denton, TX 76201-1100 | 2018-10-16 |
| 1124573092 | Specialeyes Optical, LLC | Optometrist | 1106 Alexis Ct, Mansfield, TX 76063-3338 | 2016-08-22 |
| 1679028542 | Specialeyes Optical, LLC | Optometrist | 105 River Oakes Dr., Southlake, TX 76092 | 2016-08-22 |
| Street Address |
321 S HENDERSON ST |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-1016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154301372 | Michael Griffin Hunt | Ophthalmology | 321 S Henderson St, Fort Worth, TX 76104-1016 | 2006-01-23 |
| 1255816674 | Vasantha Kumari Kanukuntla | Optometrist | 321 S Henderson St, Fort Worth, TX 76104-1016 | 2018-10-02 |
| 1942508478 | Child Vision Center | Clinic/Center | 321 S Henderson St, Fort Worth, TX 76104-1016 | 2011-03-08 |
| 1760507149 | Pediatric Eye Specialists LLP | Ophthalmology | 321 S Henderson St, Fort Worth, TX 76104-1016 | 2007-03-21 |
| 1801999149 | Alicia Denee Derry | Optometrist | 321 S Henderson St, Fort Worth, TX 76104-1016 | 2006-09-05 |
| 1346219821 | Alan Andrew Norman | Ophthalmology | 321 S Henderson St, Fort Worth, TX 76104-1016 | 2006-03-16 |
| 1366414773 | Eric Alan Packwood | Ophthalmology | 321 S Henderson St, Fort Worth, TX 76104-1016 | 2006-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| 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 |
|---|---|---|---|---|
| 1841805645 | Mary Kathryn Walters | Optometrist | 655 Taylor Street, Fort Worth, TX 76102-4821 | 2020-09-09 |
| 1053920546 | Christa Marie Widjaja | Optometrist | 1700 Montgomery St, Fort Worth, TX 76107 | 2020-07-30 |
| 1275168403 | National Vision Inc | Optometrist | 5609 Sierra Springs Ln, Fort Worth, TX 76123-2183 | 2020-03-09 |
| 1659933125 | Robert Xiang Li | Optometrist | 3524 Highway 114 Ste 300, Fort Worth, TX 76177-2197 | 2019-07-03 |
| 1134781792 | Daniel Max & Marcandrea LLC | Optometrist | 4619 S Hulen St, Suite C, Fort Worth, TX 76132 | 2019-07-03 |
| 1144782889 | Daniel Max & Marcandrea LLC | Optometrist | 8901 N. Freeway Service Rd E, Ste 105, Fort Worth, TX 76177 | 2019-04-02 |
| 1053879569 | Daniel Max & Marcandrea LLC | Optometrist | 501 Alta Mere Dr Ste 1021, Fort Worth, TX 76114-4014 | 2019-03-05 |
| 1083179600 | Joseph Khang Vu | Optometrist | 4800 S Hulen St Ste 147, Fort Worth, TX 76132-1415 | 2019-02-07 |
| 1477030567 | Brandon Ronald Lee | Optometrist | 2644 E Berry St., Fort Worth, TX 76105 | 2018-07-23 |
| 1932685682 | Jennifer Marie Wiernas | Optometrist | 6333 Camp Bowie Blvd Ste 272, Fort Worth, TX 76116-5444 | 2018-07-16 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
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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.