Organization Active NPI

Austin Family Vision

  • Optometrist
  • Austin, TX
National Provider Identifier
1003144692
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6229TG Issued in TX
Legal business name
AUSTIN FAMILY VISION
Practice address
1030 Norwood Park Blvd Ste a
Austin, TX 78753-6606
Phone
(512) 491-9707
Fax
(512) 491-9735
NPI assigned
Nov 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

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

Authorized official

Name
Chris Ly, O.D.NPI 1801984372
Title
Optometrist
Phone
(512) 491-9707

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 6229TG TX Primary

Addresses

Primary practice location

1030 Norwood Park Blvd Ste a
Austin, TX 78753-6606

Mailing address

P.O. Box 270088
Austin, TX 78727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100120000599 TX Part B Supplier - Clinic/Group Practice 8022150648 Receives reassigned benefits from 5 practitioners
Practice locations: Austin, TX; Pflugerville, TX

National Provider Directory

National Provider Directory

Locations

1030 Norwood Park Blvd
Ste A
Austin, TX 78753
Phone (512) 491-9707

Practitioners & affiliated clinicians

Practitioners 6

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": "1258675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461801600000",
    "number": "1003144692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 270088",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 NORWOOD PARK BLVD STE A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787536606",
            "telephone_number": "512-491-9707",
            "fax_number": "512-491-9735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTIN FAMILY VISION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-20",
        "last_updated": "2016-04-28",
        "status": "A",
        "authorized_official_last_name": "LY",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "512-491-9707",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6229TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.