Individual provider Active NPI

Javier Renee Zamora, OD

  • Optometrist
  • Round Rock, TX
National Provider Identifier
1003892068
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5608TG Issued in TX
Practice address
893 N I H 35
Ste. 110
Round Rock, TX 78664-4309
Phone
(512) 249-2424
Fax
(512) 248-1323
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5608TG TX Primary

Addresses

Primary practice location

893 N I H 35
Ste. 110
Round Rock, TX 78664-4309

Mailing address

893 N I H 35
Ste. 110
Round Rock, TX 78664-4309
Phone (512) 248-2424

Other identifiers 2

IdentifierTypeStateIssuer
100806202MedicaidTX
100806201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060918000100 TX Practitioner - Optometry 6608871181 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5608TXMDBehavioral Analyst
5608TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Texas Professional PLLC Optometrist CurrentSince Aug 17, 2021 Accepting new patients
Eye Clinic of Austin PLLC Optometrist Past Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients
Texan Eye, PA Optometrist Past Accepting new patients

Locations

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

501 E Palm Valley Blvd
Round Rock, TX 78664
Phone (512) 248-2424

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1003892068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "893 N I H 35",
            "address_2": "STE. 110",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786644309",
            "telephone_number": "512-248-2424",
            "fax_number": "512-248-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "893 N I H 35",
            "address_2": "STE. 110",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786644309",
            "telephone_number": "512-249-2424",
            "fax_number": "512-248-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMORA",
        "first_name": "JAVIER",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5608TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100806202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100806201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.