Oculus Interest XII, LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

OCULUS INTEREST XII, LLC

Doing business as

My EyeLab

Practice address

19504 Katy Fwy
Houston, TX 77094-1004

Phone

(346) 251-0687

Fax

(561) 828-8367

NPI assigned

Jun 19, 2020

Organization subpart

No

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

Authorized official

Name

Jackie Bennett

Title

Credentialing Manager

Phone

(619) 357-6146

Specialties & licenses 1

Addresses

Other names 1

• My EyeLab Doing business as

Tax ID family

My Eyelab2 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.

• Oculus Interest XII, LLC

  • Optometrist
  • Spring, TX
  • NPI 1013532068
  NPD tax ID

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

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613692800000",
    "number": "1083230676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20115 STUEBNER AIRLINE RD",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773795430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19504 KATY FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770941004",
            "telephone_number": "346-251-0687",
            "fax_number": "561-828-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCULUS INTEREST XII, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-19",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "619-357-6146"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "My EyeLab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Terence D Oconnor, MD
• Octagos Health Inc.
• Octavio Calvillo M.D.,PH.D.
• Oculus Cypresswood, LLC
• Oculus Interest IX, LLC
• Oculus Interests XI, LLC
• Nicholas Yoshitaka Oda
• Esther Odaibo, PMHNP-BC
• Lisa Odaibo, M.D.
• Esther Odamah, M.S., PH.D

• Eyewear Supplier in Houston, TX
• Providers in Houston, TX by specialty
• Eyewear Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.