LEAGUE CITY TEXAS STATE OPTICAL PA – Optometrist, NPI 1376620716

LEAGUE CITY TEXAS STATE OPTICAL PA is a healthcare provider. based in League city, Texas. specializing in Optometrist. The organization holds a License No. 3270TG (TX). The NPI Number for LEAGUE CITY TEXAS STATE OPTICAL PA is 1376620716

Main info

Organization
Name
LEAGUE CITY TEXAS STATE OPTICAL PA
NPI
1376620716
Phone
(281) 535-8876
Address
2700 MARINA BAY DR STE A
Authorized Official
DOUGLAS R FINGOLD OWNER OD
Enumeration Date
1 November 2006
Last Update Date
8 April 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for LEAGUE CITY TEXAS STATE OPTICAL PA

  • 2700 MARINA BAY DR STE A

    LEAGUE CITY, TX 775732480

    Phone: (281) 535-8876

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-04-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20220419001507OClinic/Group PracticeTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 77573)

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Reviews

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Frequently asked questions

How do I look up LEAGUE CITY TEXAS STATE OPTICAL PA by NPI?
Use NPI 1376620716 when you need to reference LEAGUE CITY TEXAS STATE OPTICAL PA in forms, claims, or directories.
Is LEAGUE CITY TEXAS STATE OPTICAL PA active in the national directory?
LEAGUE CITY TEXAS STATE OPTICAL PA's public NPI profile is in an active state.
What field does LEAGUE CITY TEXAS STATE OPTICAL PA work in?
You can think of LEAGUE CITY TEXAS STATE OPTICAL PA as practicing within Optometrist. Clinical services aligned with this taxonomy classification.
Does LEAGUE CITY TEXAS STATE OPTICAL PA practice in Texas?
You will see League City, Texas on file for LEAGUE CITY TEXAS STATE OPTICAL PA alongside any extra practice locations.
Is LEAGUE CITY TEXAS STATE OPTICAL PA a real provider?
This page reflects official NPPES data for NPI 1376620716. Always confirm identity and privileges with the practice and licensing boards.

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