DR. JERRY TED ROBERTS O.D. NPI 1629032768

NPI Information

NPI: 1629032768
Provider Name: DR. JERRY TED ROBERTS, O.D.
Classification: Optometrist - 152WC0802X
Specialization: Corneal and Contact Management
Entity Type: Individual
PECOS Registration: Yes
Address: 1100 STONE RD
SUITE 2020
KILGORE, TX
ZIP 75662
Phone: (903) 983-2020

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NPI Details

DR. Jerry Ted Roberts, O.D. is a corneal and contact management optometrist in Kilgore, TX with 50 years of experience. The provider is the professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. DR. Jerry Ted Roberts, O.D. NPI is 1629032768. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF HOUSTON - COLLEGE OF OPTOMETRY
Graduation Year:1976

The provider's business location address is:

1100 STONE RD
SUITE 2020
KILGORE, TX
ZIP 75662-482
Phone: (903) 983-2020
Fax: (903) 983-4000

The NPI 1629032768 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

Established patient complete exam of visual system (HCPCS:92014)
Photography of the retina (HCPCS:92250)
Established patient problem focused exam of visual system (HCPCS:92012)

The enumeration date for this NPI number is 4/14/2006 and was last updated on 2/11/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	152WC0802X	Optometrist	Corneal and Contact Management	TX2344TG	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	168830001	OTHER	TEXAS	CIGNA GOVERNMENT
2	83381E	OTHER	TEXAS	BLUE CROSS BLUE SHIELD
3	T1577	MEDICARE UPIN	TEXAS
4	019369001	MEDICAID	TEXAS
5	83381E	MEDICARE PIN	TEXAS
6	410022897	OTHER	TEXAS	PALMETTO GBA RAILROAD MED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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