DR. JERRY TED ROBERTS (NPI# 1629032768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629032768 |
Entity Type | Individual |
Full Name | DR. JERRY TED ROBERTS |
Credential | O.D. |
Practice Address |
1100 Stone Rd Suite 2020 Kilgore TX 75662-5482 |
Practice Telephone | 9039832020 |
Practice Fax Number | 9039834000 |
Mailing Telephone | 9039832020 |
Mailing Fax Number | 9039834000 |
Enumeration Date | 2006-04-14 |
Last Update Date | 2008-02-11 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
TX2344TG | TX | Eye and Vision Services Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | BLUE CROSS BLUE SHIELD | 83381E | 01 |
TX | CIGNA GOVERNMENT | 168830001 | 01 |
TX | 019369001 | 05 | |
TX | PALMETTO GBA RAILROAD MED | 410022897 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215912464 | Jerry D Roberts | Optometrist | 279 N Gardner St, Scottsburg, IN 47170 | 2005-12-09 |
1629395405 | Jerry Thomas Roberts | Podiatrist | 117 Tradepark Dr, Somerset, KY 42503-3428 | 2010-05-03 |
1336274240 | Jerry D Roberts | Occupational Therapist | 205 N Tracy Ave, Bozeman, MT 59715-3564 | 2007-02-22 |
1093761884 | Jerry M. Roberts | Pediatrics | 4000 Shakerag Hl, Suite 201, Peachtree City, GA 30269-4047 | 2006-05-25 |
1033180336 | Jerry D Roberts | Optometrist | 507 E Cleveland Ave, Monett, MO 65708-1750 | 2006-01-27 |
Street Address |
1100 STONE RD SUITE 2020 |
City | KILGORE |
State | TX |
Zip Code | 75662-5482 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043840291 | Charity Michal Anderson | Counselor | 1100 Stone Rd, Kilgore, TX 75662-5482 | 2020-01-16 |
1265736961 | Kyle David Ferro | Dentist | 1100 Stone Rd, Suite 265, Kilgore, TX 75662-5482 | 2011-01-10 |
1710219720 | Totalcare Comprehensive Home Health Supply | Durable Medical Equipment & Medical Supplies | 1100 Stone Rd, Suite 105, Kilgore, TX 75662-5482 | 2010-02-02 |
1518105311 | Nita J Childers | Counselor | 1100 Stone Rd, Suite 102, Kilgore, TX 75662-5482 | 2009-02-02 |
1851557169 | Christopher Richard Gratton, D.c., P.C. | Chiropractor | 1100 Stone Rd, Suite 269, Kilgore, TX 75662-5482 | 2008-08-06 |
1063607141 | Damona M Depriest | Social Worker | 1100 Stone Rd, Suite 102 Behavioral Emotional Counseling Services, Kilgore, TX 75662-5494 | 2007-09-11 |
1952593311 | Jadie Bolton Roberts | Optometrist | 1100 Stone Rd, Suite 2020, Kilgore, TX 75662-5482 | 2007-08-09 |
1366535288 | Jeffrey L Davis | Dentist | 1100 Stone Rd, Suite 265, Kilgore, TX 75662-5482 | 2006-10-02 |
1740371277 | Felicia H Whitaker | Counselor | 1100 Stone Rd, Suite 102 Behavioral Emotional Counseling Services, Kilgore, TX 75662-5494 | 2006-09-28 |
1184655649 | Kilgore-gilmer Eye Care Centers P.a. | Optometrist | 1100 Stone Rd, Suite 2020, Kilgore, TX 75662-5482 | 2006-07-05 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346890621 | Linda Gail Watson | Technician | 190 Glendale St, Kilgore, TX 75662 | 2019-09-18 |
1174185151 | Jennifer Darlene Franks | Registered Nurse | 6144 Gateway Center Pmb # 320, Kilgore, TX 75662 | 2019-07-01 |
1215363312 | Kilgore Integrated Health Pllc | Chiropractor | 726 Us Highway 259 N, Kilgore, TX 75662 | 2013-09-20 |
1407172240 | Jeffrey Alan Davis | Specialist/Technologist | 300 N. Kilgore Street, Kilgore, TX 75662 | 2010-04-19 |
1396923777 | Rachel Thunder Rose Wyatt | Physical Therapist | 1200 Dudley Road, Kilgore, TX 75662 | 2008-02-07 |
1346313673 | Brookshire Grocery Company | Pharmacy | 747 Hwy 259 North, Attention Pharmacy Dept, Kilgore, TX 75662 | 2006-11-16 |
1417026451 | Jeffery John Pinkerton | Optometrist | 800 Highway 259 North, Kilgore, TX 75662 | 2006-11-06 |
1831205004 | Joseph Claude De Graffenried Jr. | Dentist | 238 Lawrence St, Kilgore, TX 75662 | 2006-08-21 |
1235159500 | Charles Robert Cottier | Chiropractor | 316 Henderson, Kilgome, TX 75662 | 2006-07-20 |
1346509494 | Kelton Hospice, Inc. | Hospice Care, Community Based | 1100 Stone Road, Suite 269, Kilgore, TX 75662 | 2012-05-10 |
Find all providers in zip 75662 |
Taxonomy Code | 152WC0802X |
Grouping | Eye and Vision Services Providers |
Classification | Optometrist |
Specialization | Corneal and Contact Management |
The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760004840 | Dripping Springs Vision Center, Pa | Optometrist | 750 W Highway 290, Dripping Springs, TX 78620-3861 | 2020-05-12 |
1427693621 | Huynh Vision Services Inc PC | Optometrist | 1405 W Berry St, Ft Worth, TX 76110-3814 | 2019-11-12 |
1992367460 | Budaful Eyes Pllc | Optometrist | 15550 S Ih 35 Frontage Rd, 107, Buda, TX 78610 | 2019-07-03 |
1831631134 | Divine Innovations Pllc | Optometrist | 6646 S Staples St Ste 108, Corpus Christi, TX 78413-5426 | 2016-11-17 |
1679024384 | Chao and Yi Eye Associates, PC | Optometrist | 9722 Gaston Road, Suite: 170, Katy, TX 77494 | 2016-10-18 |
1811344674 | Rayford Eye Associates, Pllc | Optometrist | 2833 Riley Fuzzel Rd., #300, Spring, TX 77386 | 2016-05-20 |
1902224173 | Doris D Forte | Optometrist | 11341 Hillard Street, Ellington Air Station, Houston, TX 77034 | 2014-04-03 |
1770922338 | Napoleon Cabaguio Lovero II | Optometrist | 520 Waugh Drive, Houston, TX 77019 | 2013-06-17 |
1093052128 | Renaissance Eyecare | Optometrist | 2900 East Berry Street Suite 101, Fort Worth, TX 76105-4755 | 2013-01-09 |
1851636989 | Trophy Club Vision Care LLP | Optometrist | 2001 E Highway 114 Ste 180, Trophy Club, TX 76262-6656 | 2012-11-29 |
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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.