SAM'S CLUB OPTICAL (NPI# 1356438931) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356438931 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-8280 |
| Practice Address |
11360 Pellicano Dr El Paso TX 79936-5904 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 9155916688 |
| 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 30-8280 | 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 |
11360 PELLICANO DR |
| City | EL PASO |
| State | TX |
| Zip Code | 79936-5904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104882745 | Higinio Cantres-carmona | Optometrist | 11360 Pellicano Dr, El Paso, TX 79936-5904 | 2006-04-22 |
| 1134729130 | Mariam Shahabi | Pharmacist | 11360 Pellicano Dr, El Paso, TX 79936-5904 | 2020-10-28 |
| 1003322397 | Carmona Eye Care Pllc | Optometrist | 11360 Pellicano Dr, El Paso, TX 79936-5904 | 2017-12-21 |
| 1114944238 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 11360 Pellicano Dr, El Paso, TX 79936-5904 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285233171 | Center At Zaragoza, LLC | Skilled Nursing Facility | 12660 Pebble Hills Blvd., El Paso, TX 79936 | 2020-10-21 |
| 1346889953 | Georges Chiropractic and Wellness Center, Pa | Chiropractor | 1400 N Zaragosa Suite D, El Paso, TX 79936 | 2019-12-30 |
| 1316597768 | Larry Felix | Specialist/Technologist | 11720 Teachers Dr., El Paso, TX 79936 | 2019-09-18 |
| 1508323486 | Aaron John Palos | Pharmacist | 11320 Montwood, Pharmacy, El Paso, TX 79936 | 2019-02-27 |
| 1366919508 | Katrina Belvin | Social Worker | 1390 Georger Dieter Dr., #140, El Paso, TX 79936 | 2018-10-25 |
| 1063993244 | Assisted Living | Meals | 11065 Tom Weiskopf Dr, El Paso, TX 79936 | 2018-08-24 |
| 1588142962 | Miriam Salazar | Occupational Therapy Assistant | 1351 James Watt Dr., El Paso, TX 79936 | 2018-07-30 |
| 1902315179 | David Galindo | Occupational Therapist | 1415 Zaragoza, El Paso, TX 79936 | 2017-09-20 |
| 1861915589 | Lizette Salcido | Behavior Technician | 3221 Running Deer Dr., El Paso, TX 79936 | 2017-07-25 |
| 1659801264 | Edith Nneoma Vincent | Registered Nurse | 11829 Gwen Evans Ln, El Paso, TX 79936 | 2017-06-15 |
| Find all providers in zip 79936 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861904112 | Javier Moriel | Technician/Technologist | 4504 Montana Ave, El Paso, TX 79903-4706 | 2017-10-26 |
| 1023567294 | National Vision, Inc. | Technician/Technologist | 6101 Gateway Blvd W # Op06, El Paso, TX 79925-3416 | 2016-09-28 |
| 1962807669 | Sam's East, Inc. | Technician/Technologist | 9498 Gateway North, El Paso, TX 79924 | 2014-10-24 |
| 1376809368 | Alejandro Ramirez | Technician/Technologist | 1821 N Zaragoza Rd Ste 208a, El Paso, TX 79936-7912 | 2012-04-04 |
| 1407120868 | Wal-mart Stores Texas LLC | Technician/Technologist | 5631 Dyer St, El Paso, TX 79904-6204 | 2012-03-02 |
| 1740563774 | Karla Magdalena Herrera | Technician/Technologist | 2400 Texas Ave, El Paso, TX 79901-2123 | 2011-09-26 |
| 1851673719 | Irma Frances Lopez | Technician/Technologist | 109 Mccarthy Ave Ste A, El Paso, TX 79915-3813 | 2011-09-15 |
| 1578870705 | Opticas Franklin Optical LLC | Technician/Technologist | 1821 N Zaragoza Rd, Ste. 208-a, El Paso, TX 79936-7912 | 2010-09-09 |
| 1245415967 | Manuel Lazos | Technician/Technologist | 3202a N Piedras St, El Paso, TX 79930-3704 | 2007-12-31 |
| 1922208693 | Blanca E Licon | Technician/Technologist | 1830 George Dieter Dr Ste 103, El Paso, TX 79936-4305 | 2007-07-20 |
| Find all providers in EL PASO | ||||
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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.