Organization Active NPI

Lifetime Vision Care Texas, PLLC

  • Optometrist
  • Round Rock, TX
National Provider Identifier
1053704940
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7253TG Issued in TX
Legal business name
LIFETIME VISION CARE TEXAS, PLLC
Doing business as
Lifetime Vision Care
Practice address
408 N Mays St
Round Rock, TX 78664-4317
Phone
(512) 244-2003
Fax
(512) 949-5120
NPI assigned
Mar 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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

Authorized official

Name
Christopher Eugenio, O.D.NPI 1477700060
Title
President/Owner
Phone
(512) 244-2003

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 7253TG TX Primary

Addresses

Primary practice location

408 N Mays St
Round Rock, TX 78664-4317

Mailing address

408 N Mays St
Round Rock, TX 78664-4317
Phone (512) 244-2003

Other names 1

  • Lifetime Vision Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150625000105 TX Part B Supplier - Clinic/Group Practice 2668783150 Receives reassigned benefits from 2 practitioners
Practice locations: Round Rock, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426464000000",
    "number": "1053704940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 N MAYS ST",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786644317",
            "telephone_number": "512-244-2003",
            "fax_number": "512-949-5120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 N MAYS ST",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786644317",
            "telephone_number": "512-244-2003",
            "fax_number": "512-949-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME VISION CARE TEXAS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-16",
        "last_updated": "2015-03-16",
        "status": "A",
        "authorized_official_last_name": "EUGENIO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "512-244-2003",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7253TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.