SPECIALEYES OPTICAL, LLC (NPI# 1679028542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679028542 |
| Entity Type | Organization |
| Organization Name | SPECIALEYES OPTICAL, LLC |
| Practice Address |
105 River Oakes Dr. Southlake TX 76092 |
| Mailing Address |
321 S Henderson St Fort Worth TX 76104-1016 |
| Practice Telephone | 8175299949 |
| Practice Fax Number | 8175299943 |
| Mailing Telephone | 8175299949 |
| Mailing Fax Number | 2175299943 |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2016-08-22 |
| Authorized Official Name | DR. ERIC ALAN PACKWOOD (MEMBER) |
| Authorized Official Telephone | 8175299949 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 7350TG | TX | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 018440004 | 05 | |
| TX | 287401803 | 05 | |
| TX | 207716601 | 05 | |
| TX | 145291402 | 05 | |
| TX | 294486001 | 05 | |
| TX | 323588905 | 05 | |
| TX | 166926901 | 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 |
| 1891150058 | Specialeyes Optical, LLC | Optometrist | 321 S Henderson St, Fort Worth, TX 76104-1016 | 2015-12-15 |
| Street Address |
105 RIVER OAKES DR. |
| City | SOUTHLAKE |
| State | TX |
| Zip Code | 76092 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730718990 | Elizabeth Beazley | Family Medicine | 1050 E. Hwy 114 Suite 100, Southlake, TX 76092 | 2020-04-08 |
| 1518508894 | Arbor Pediatrics, Pllc | Pediatrics | 1130 N Kimball Ave, Southlake, TX 76092 | 2019-10-08 |
| 1346882685 | Gs Ortho Assists, Pllc | Physician Assistant | 2600 East Southlake Boulevard Suite 120, Southlake, TX 76092 | 2019-10-08 |
| 1609340496 | Rebecca Leigh Lander | Physician Assistant | 1170 N Carroll Ave., Southlake, TX 76092 | 2019-01-15 |
| 1225506223 | Physicians Wellness Associates Pllc | Family Medicine | 1920 East State Highway 114, Southlake, TX 76092 | 2018-11-07 |
| 1740762459 | Brandi L. Barker | Chiropractor | 590 N. Kimball Ave, Suite 140, Southlake, TX 76092 | 2018-08-30 |
| 1033699228 | Julie A. Seeber | Physical Therapy Assistant | 170 Stonebridge Lane, Southlake, TX 76092 | 2018-08-16 |
| 1992281364 | Alayna Powers | Nurse Practitioner | 900 E Southlake Blvd Ste 300, Southlake, TX 76092 | 2018-07-18 |
| 1346732153 | Amrittej Singh Virk | Dentist | 630 N Kimball Ave Ste 110, Southlake, TX 76092 | 2018-06-06 |
| 1740779594 | Radiant Family Dental Pllc | Dentist | 2012 Southlake Glen Dr., Southlake, TX 76092 | 2018-05-08 |
| Find all providers in zip 76092 | ||||
| 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 |
|---|---|---|---|---|
| 1104487271 | Lilit Saakova | Optometrist | 1251 E Southlake Blvd Ste 333, Southlake, TX 76092-6478 | 2019-06-27 |
| 1518488576 | Christopher John Steritz | Optometrist | 1021 E Southlake Blvd, Southlake, TX 76092-6347 | 2017-06-29 |
| 1063641587 | Karen Liu | Optometrist | 1980 E. State Highway 114, Southlake, TX 76092-6510 | 2009-07-06 |
| 1952500159 | Manoj Abraham | Optometrist | 1251 E Southlake Blvd, Suite 331, Southlake, TX 76092-6478 | 2007-07-17 |
| 1548388358 | Michelle Lynay Perry | Optometrist | 2904 Yorkshire Ct, Southlake, TX 76092-5626 | 2007-03-27 |
| 1881759785 | Zanella Optometry, Pllc | Optometrist | 1251 E. Southlake Blvd Suite 331, Southlake, TX 76092 | 2006-12-22 |
| 1497813646 | Deborah Zanella | Optometrist | 1251 East Southlake Boulevard, Suite 331, Southlake, TX 76092 | 2006-12-04 |
| 1578637393 | David Shie Chiang | Optometrist | 2601 E Northwest Pkwy, Southlake, TX 76092-6668 | 2006-11-20 |
| 1235201831 | Branon Zane Marsh | Optometrist | 670 E Southlake Blvd, Southlake, TX 76092-6236 | 2006-11-15 |
| 1013013051 | Tami Lea Hannaman | Optometrist | 3004 E Southlake Blvd, Southlake, TX 76092 | 2006-09-16 |
| Find all providers in SOUTHLAKE | ||||
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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.