Basic Information
| Provider Information | |||||||||
| NPI: | 1154328870 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOOPER | ||||||||
| FirstName: | JOSHUA | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | OD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 846098 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752846098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9033246450 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1327 TROUP HWY | ||||||||
| Address2: | |||||||||
| City: | TYLER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 757014443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9035314733 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2005 | ||||||||
| LastUpdateDate: | 10/13/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 6589TG | TX | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 925395 | 01 | TX | WEB-TPA | OTHER | 0038FF | 01 | TX | TEXAS COMMUNITY CARE | OTHER | 0038FF | 01 | TX | TEXAS TRUE CHOICE | OTHER | 11450424 | 01 | TX | AETNA TRS CARE | OTHER | 202043539 | 01 | TX | TRICARE SOUTH | OTHER | 5451470001 | 01 | TX | STERLING OPTION I | OTHER | 0038FF | 01 | TX | HEALTHFIRST TPA | OTHER | 11450424 | 01 | TX | AETNA | OTHER | 81256Q | 01 | TX | BLUE CROSS BLUE SHIELD GOVERNMENT | OTHER | 0038FF | 01 | TX | SUPERIOR VISION | OTHER | 5451470001 | 01 | TX | CIGNA GOVERNMENT SERVICES | OTHER | 921841 | 01 | TX | BLOCK VISION | OTHER | 9370971 | 01 | TX | PHCS | OTHER | 0038FF | 01 | TX | UNITED HEALTH CARE | OTHER | 22704 | 01 | TX | NATIONAL VISION ADMINISTRATORS | OTHER | 170498302 | 05 | TX | MEDICAID | 22704 | 01 | TX | ALWAYS VISION | OTHER | 5451470001 | 01 | TX | STERLING OPTION II | OTHER | 0038FF | 01 | TX | VISION SERVICE PLAN | OTHER | 0038FF | 01 | TX | PRINICIPAL FINANCIAL GROUP | OTHER | 0038FF | 01 | TX | GROUP & PENSION ADMINISTRATORS | OTHER | 170498303 | 05 | TX | MEDICAID | TIN PLUS 021 | 01 | TX | TRICARE | OTHER | 0038FF | 01 | TX | VISION CARE PLAN | OTHER | 60583 | 01 | TX | SAFEGUARD | OTHER | 81256Q | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | 82840Q | 01 | TX | BCBS | OTHER | 9370971 | 01 | TX | BENEFIT PLANNERS | OTHER | HO96271 | 01 | TX | INEGRATED HEALTH PLAN | OTHER | TIN PLUS 015 | 01 | TX | TRICARE TC EYE JV LOCATION | OTHER |