DR. JERRY TED ROBERTS


Address: 1100 Stone Rd, Suite 2020, Kilgore, TX 75662-5482
Phone: 9039832020

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

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

Other Providers JERRY ROBERTS

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

Office Location

Street Address 1100 STONE RD
SUITE 2020
City KILGORE
State TX
Zip Code 75662-5482

Providers in the same location

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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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 152WC0802X
Grouping Eye and Vision Services Providers
Classification Optometrist
Specialization Corneal and Contact Management

Taxonomy Definition

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]

Providers in the same taxonomy and state

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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Competitor

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City KILGORE
Zip Code 75662

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Dataset Information

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.

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