Organization Active NPI

Elysian Eyecare PLLC

Doing business as Unique Vision

  • Clinic/Center
  • Mansfield, TX
National Provider Identifier
1013502004
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
ELYSIAN EYECARE PLLC
Doing business as
Unique Vision
Practice address
1971 Highway 287 N Ste 105
Mansfield, TX 76063-8983
Phone
(817) 453-7591
Fax
(817) 453-7715
NPI assigned
Mar 2, 2021
Last updated
Mar 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Authorized official

Name
Phuong Pham, ODNPI 1932753027
Title
Optometrist
Phone
(347) 279-1020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1971 Highway 287 N Ste 105
Mansfield, TX 76063-8983

Mailing address

1971 Highway 287 N Ste 105
Mansfield, TX 76063-8983
Phone (817) 453-7591

Other names 1

  • Unique Vision Doing business as

National Provider Directory

National Provider Directory

Locations

1971 Highway 287 N
Ste 1
Mansfield, TX 76063
Phone (817) 453-7591

1971 Highway 287 N
Ste 105
Mansfield, TX 76063
Phone (682) 518-7565

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1013502004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1971 HIGHWAY 287 N STE 105",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638983",
            "telephone_number": "817-453-7591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1971 HIGHWAY 287 N STE 105",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760638983",
            "telephone_number": "817-453-7591",
            "fax_number": "817-453-7715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELYSIAN EYECARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "PHUONG",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "347-279-1020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Unique Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.