Organization Active NPI

Infinity Vision Associates PLLC

  • Optometrist
  • Carrollton, TX
National Provider Identifier
1033540265
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7822TG Issued in TX
Legal business name
INFINITY VISION ASSOCIATES PLLC
Practice address
4009 Old Denton Rd
Suite 124
Carrollton, TX 75007-1000
Phone
(972) 939-6567
Fax
(972) 939-6268
NPI assigned
Dec 13, 2013
Last updated
Dec 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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

Authorized official

Name
Bryan Nathan Kuder, ODNPI 1760762835
Title
Owner
Phone
(972) 939-6567

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 7822TG TX Primary

Addresses

Primary practice location

4009 Old Denton Rd
Suite 124
Carrollton, TX 75007-1000

Mailing address

4009 Old Denton Rd
Suite 124
Carrollton, TX 75007-1000
Phone (972) 939-6567

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140312001535 TX Part B Supplier - Clinic/Group Practice 2163652173 Receives reassigned benefits from 2 practitioners
Practice locations: Carrollton, TX

National Provider Directory

National Provider Directory

Locations

4009 Old Denton Rd
Ste 124
Carrollton, TX 75007
Phone (972) 939-6567

Practitioners & affiliated clinicians

Practitioners 4

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": "1386892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386892800000",
    "number": "1033540265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 OLD DENTON RD",
            "address_2": "SUITE 124",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750071000",
            "telephone_number": "972-939-6567",
            "fax_number": "972-939-6268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4009 OLD DENTON RD",
            "address_2": "SUITE 124",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750071000",
            "telephone_number": "972-939-6567",
            "fax_number": "972-939-6268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITY VISION ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-13",
        "last_updated": "2013-12-13",
        "status": "A",
        "authorized_official_last_name": "KUDER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-939-6567",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7822TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; 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.