NPIMap

Organization Active NPI

Eye Clinic of Austin PLLC Thomas Henderson Sole MBR

Doing business as Eye Clinic of Austin

  • Ophthalmology Physician
  • Austin, TX
National Provider Identifier
1053403543
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
F4863 Issued in TX
Legal business name
EYE CLINIC OF AUSTIN PLLC THOMAS HENDERSON SOLE MBR
Doing business as
Eye Clinic of Austin
Practice address
3410 Far West Blvd
Suite 140
Austin, TX 78731-3167
Phone
(512) 427-1100
Fax
(512) 427-1207
NPI assigned
Sep 29, 2006
Last updated
Mar 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2012

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

Authorized official

Name
Dr. Thomas Thoman Henderson, MDNPI 1407045339
Title
President Ceo
Phone
(512) 427-1100

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
Ophthalmology Physician 207W00000X F4863 TX Primary

Addresses

Primary practice location

3410 Far West Blvd
Suite 140
Austin, TX 78731-3167

Mailing address

3410 Far West Blvd
Suite 140
Austin, TX 78731-3167
Phone (512) 427-1100

Other identifiers 4

IdentifierTypeStateIssuer
93945601MedicaidTX
115509501MedicaidTX
180008032OtherTXMEDICARE RAILROAD GRP
612710001OtherTXNATIONAL SUPPLIER CLEARIN

Other names 1

  • Eye Clinic of Austin Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eye Care Austin2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3410 Far West Blvd
Ste 140
Austin, TX 78731
Phone (512) 427-1100

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": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1053403543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 FAR WEST BLVD",
            "address_2": "SUITE 140",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787313167",
            "telephone_number": "512-427-1100",
            "fax_number": "512-427-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 FAR WEST BLVD",
            "address_2": "SUITE 140",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787313167",
            "telephone_number": "512-427-1100",
            "fax_number": "512-427-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CLINIC OF AUSTIN PLLC THOMAS HENDERSON SOLE MBR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "THOMAN",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "512-427-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "F4863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93945601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115509501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD GRP",
            "identifier": "180008032",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL SUPPLIER CLEARIN",
            "identifier": "612710001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Clinic of Austin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 28, 2012; 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.