Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.
JANET ILIDAN
Complete NPI Record 1831599539
Optometrist in Jbsa Lackland, TX
Active since August 29, 2014PECOS Enrolled
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236(210) 292-6255(210) 292-7934 Get Directions
Complete NPI Dataset
This page contains the complete raw NPPES record for Janet Ilidan (NPI 1831599539), an individual optometrist provider in Jbsa Lackland, TX. All 26 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: 1831599539 Field 1/26
- 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: 1 Field 2/26
- 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).
- Provider Last Name Legal Name: ILIDAN Field 3/26
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: JANET Field 4/26
- The first name of the provider, if the provider is an individual.
- Provider First Line Business Mailing Address: 9510 FRENCH TREE Field 5/26
- 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: HELOTES Field 6/26
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: TX Field 7/26
- 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: 780234468 Field 8/26
- 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 9/26
- 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 Business Mailing Address Telephone Number: 9403370104 Field 10/26
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider First Line Business Practice Location Address: 1100 WILFORD HALL LOOP BLDG 4554 Field 11/26
- 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: JBSA LACKLAND Field 12/26
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: TX Field 13/26
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 782365638 Field 14/26
- 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 15/26
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 2102926255 Field 16/26
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 2102927934 Field 17/26
- The fax number associated with the location address of the provider being identified.
- Provider Gender Code: F Field 20/26
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 152W00000X Field 21/26
- 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.
- Provider License Number 1: 9348 Field 22/26
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: TX Field 23/26
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 24/26
- 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 Sole Proprietor: Y Field 25/26
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
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