Brazos Valley Eye Physicians PA

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

BRAZOS VALLEY EYE PHYSICIANS PA

Practice address

5002 Lakeland Cir Ste a
Waco, TX 76710-2900

Phone

(254) 752-2571

Fax

(254) 752-0699

NPI assigned

Apr 11, 2006

Organization subpart

No

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

Authorized official

Name

Scott H Smith, MDNPI 1750355442

Title

Owner

Phone

(254) 752-2571

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Scott H Smith, MD

  • Ophthalmology Physician
  • Waco, TX
  • NPI 1750355442

  Specialist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661904000000",
    "number": "1063475911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 LAKELAND CIR STE A",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767102900",
            "telephone_number": "254-752-2571",
            "fax_number": "254-752-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 LAKELAND CIR STE A",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767102900",
            "telephone_number": "254-752-2571",
            "fax_number": "254-752-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAZOS VALLEY EYE PHYSICIANS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-752-2571",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154968501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rochelle B Breemes
• Alex A Breitenwischer, MS, LAT, ATC
• Brent L Kutach DO PA
• Bret H Miller MD PA Orthopaedic and Sports Medicine Specialists of Wac
• Jacquelyn Joy Brewer, PA-C

• Specialist in Waco, TX
• Providers in Waco, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.