Organization Active NPI

Abilene Advanced Eyecare Inc.

  • Optometrist
  • Abilene, TX
National Provider Identifier
1104001643
Registry record updated Feb 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TX6293TG Issued in TX
Legal business name
ABILENE ADVANCED EYECARE INC.
Practice address
4734 S 14TH
Abilene, TX 79605-4733
Phone
(325) 692-9596
Fax
(325) 690-6191
NPI assigned
Jan 3, 2008
Last updated
Feb 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2008

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

Authorized official

Name
Dr. Gabriel Avila, O.D.NPI 1487730651
Title
Optometrist/Owner
Phone
(325) 692-9596

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 TX6293TG TX Primary

Addresses

Primary practice location

4734 S 14TH
Abilene, TX 79605-4733

Mailing address

4734 South 14TH
Abilene, TX 79605-4733
Phone (325) 692-9596

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031223000822 TX Part B Supplier - Clinic/Group Practice 6002714342 Receives reassigned benefits from 6 practitioners
Practice locations: Abilene, TX; Stamford, TX

National Provider Directory

National Provider Directory

Locations

719 W Main St
Eastland, TX 76448
Phone (254) 631-0200

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203033600000",
    "number": "1104001643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4734 SOUTH 14TH",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796054733",
            "telephone_number": "325-692-9596",
            "fax_number": "325-690-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4734 S 14TH",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796054733",
            "telephone_number": "325-692-9596",
            "fax_number": "325-690-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABILENE ADVANCED EYECARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-02-15",
        "status": "A",
        "authorized_official_last_name": "AVILA",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "325-692-9596",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "TX6293TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.