Organization Active NPI

Eye and Vision Management

  • Optometrist
  • Richardson, TX
National Provider Identifier
1003006057
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4044TG Issued in TX
Legal business name
EYE AND VISION MANAGEMENT
Practice address
3417 Spectrum Blvd
Suite 100
Richardson, TX 75082-9705
Phone
(972) 423-3937
NPI assigned
Jul 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Agustin L Gonzalez, OD
Title
Partner
Phone
(972) 423-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 4044TG TX Primary

Addresses

Primary practice location

3417 Spectrum Blvd
Suite 100
Richardson, TX 75082-9705

Mailing address

3417 Spectrum Blvd
Suite 100
Richardson, TX 75082-9705
Phone (972) 423-3937

Other identifiers 1

IdentifierTypeStateIssuer
0453227MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185408000000",
    "number": "1003006057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 SPECTRUM BLVD",
            "address_2": "SUITE 100",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750829705",
            "telephone_number": "972-423-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 SPECTRUM BLVD",
            "address_2": "SUITE 100",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750829705",
            "telephone_number": "972-423-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE AND VISION MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-07-26",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "AGUSTIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "972-423-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4044TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0453227",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.