Individual provider Active NPI

Louis J Peters, O.D.

  • Corneal and Contact Management Optometrist
  • San Antonio, TX
National Provider Identifier
1013074731
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
04858T Issued in TX
Practice address
11703 Huebner Rd
Suite 109
San Antonio, TX 78230-1201
Phone
(210) 979-6440
Fax
(210) 558-8310
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 04858T TX
Corneal and Contact Management Optometrist 152WC0802X 04858T TX Primary

Addresses

Primary practice location

11703 Huebner Rd
Suite 109
San Antonio, TX 78230-1201

Mailing address

11703 Huebner Rd
Suite 109
San Antonio, TX 78230-1201
Phone (210) 979-6440

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
I20220802000878 TX Practitioner - Optometry 6002861440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

120 Empresario Dr
Suite 111
San Antonio, TX 78245-4012
Phone (210) 957-0770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04858TTXMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Texas Professional PLLC Optometrist CurrentSince Aug 1, 2022 Accepting new patients
Peters Eye Care, Inc. Optometrist Past Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients

Locations

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

120 Empresario Dr
Ste 111
San Antonio, TX 78245
Phone (210) 257-0940

Networks

  • NM HMO C-SNP
  • TX HMO D-SNP
  • TX HMO

Organizations & group practices 3

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197504000000",
    "number": "1013074731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11703 HUEBNER RD",
            "address_2": "SUITE 109",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301201",
            "telephone_number": "210-979-6440",
            "fax_number": "210-558-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11703 HUEBNER RD",
            "address_2": "SUITE 109",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301201",
            "telephone_number": "210-979-6440",
            "fax_number": "210-558-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "LOUIS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "04858T",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "04858T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.