MY EYE LAB GARLAND
Complete NPI Record 1548818529
Eyewear Supplier in Garland, TX

Active since September 03, 2019
4280 LAVON DR STE 236B, GARLAND, TX 75040(469) 722-1820(561) 828-8367 Get Directions

NPPES record last updated: February 19, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 19, 2021, Sep 3, 2019 (2 updates tracked since 2019).

Complete NPI Dataset

This page contains the complete raw NPPES record for My Eye Lab Garland (NPI 1548818529), an eyewear supplier organization in Garland, TX. All 28 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.

Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.

Registry File Document Utilities
NPI: 1548818529
Field 1/28
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Field 2/28
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: Not available
Field 3/28
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business Name: MEL GARLAND 1 LLC
Field 4/28
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization Name: MY EYE LAB GARLAND
Field 5/28
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code: 3
Field 6/28
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address: 1784 W MCDERMOTT DR STE 110
Field 7/28
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City Name: ALLEN
Field 8/28
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: TX
Field 9/28
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 750133395
Field 10/28
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US
Field 11/28
The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider First Line Business Practice Location Address: 4280 LAVON DR STE 236B
Field 12/28
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: GARLAND
Field 13/28
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: TX
Field 14/28
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 750402971
Field 15/28
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
Field 16/28
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 4697221820
Field 17/28
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 5618288367
Field 18/28
The fax number associated with the location address of the provider being identified.
Authorized Official Last Name: BENNETT
Field 21/28
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: JACKIE
Field 22/28
The first name of the authorized official.
Authorized Official Title or Position: CREDENTIALING SUPERVISOR
Field 23/28
The title or position of the authorized official.
Authorized Official Telephone Number: 5614336009
Field 24/28
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 332H00000X
Field 25/28
This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Field 26/28
This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Is Organization Subpart: N
Field 27/28
Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
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