Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jack Greenan

Individual provider Optometrist · NPI 1639613979

Jack Greenan is an Optometry in Texarkana, Texas. Qualified in 2016, 10 years ago. Practices with Aeg Texas Professional PLLC, a 228-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
10
Licensed in
TX
In the registry since
2016
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Practice location Address checks out

2703 Richmond Rd
Texarkana, TX 75503-2328
Phone: (903) 838-0783
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 9121T (TX)

Record details

NPI number1639613979
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 6, 2016
Last updated in NPPESJune 3, 2019
Mailing address2703 Richmond Rd, Texarkana, TX 75503-2328

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Aeg Texas Professional Pllc — 228 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Texarkana