Bluebonnet Optometry, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

BLUEBONNET OPTOMETRY, PLLC

Doing business as

Bluebonnet Optometry

Practice address

9610 State Highway 151 Ste 103
San Antonio, TX 78251-4847

Phone

(210) 996-2008

NPI assigned

Jun 27, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Judy GandaraNPI 1811252794

Title

Owner

Phone

(858) 699-2083

Specialties & licenses 1

Addresses

Other names 1

• Bluebonnet Optometry Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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

• Judy Rivera Gandara, O.D.

  • Optometrist
  • San Antonio, TX
  • NPI 1811252794
  Medicare reassignment NPD Authorized official
• Marlen Saras Mata, OD

  • Optometrist
  • San Antonio, TX
  • NPI 1043887524
  Medicare reassignment NPD

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659916800000",
    "number": "1083346175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9610 STATE HIGHWAY 151 STE 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514847",
            "telephone_number": "210-750-1100",
            "fax_number": "210-750-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9610 STATE HIGHWAY 151 STE 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514847",
            "telephone_number": "210-996-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEBONNET OPTOMETRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "GANDARA",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-699-2083",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bluebonnet Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victoria Anjernette Blue
• Jack Bluebird II, DPT
• Bluebonnet Accessibility LLC
• Bluebonnet Counseling Services of South Texas
• Bluebonnet Eye Care
• Bluebonnet Oral Surgery and Implants PLLC
• Bluebonnet Therapy
• Jamie Bluemel, PSY.D.
• Blueoak Psychiatry PLLC
• Bluesky Home Care LLC

• Optometrist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.