Organization Active NPI

Henderson Vision Group PA

  • Optometrist
  • Houston, TX
National Provider Identifier
1104976364
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
HENDERSON VISION GROUP PA
Practice address
2518 Richmond Ave
Houston, TX 77098-3209
Phone
(713) 522-2522
Fax
(713) 522-5330
NPI assigned
Jan 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Authorized official

Name
Mark P. Pickering, O.D.
Title
President
Phone
(713) 995-0042

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2518 Richmond Ave
Houston, TX 77098-3209

Mailing address

2518 Richmond Ave
Houston, TX 77098-3209
Phone (713) 522-2522

Other names 1

  • PERFECT VISION EYECARE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101215000528 TX Part B Supplier - Clinic/Group Practice 3072700137 Receives reassigned benefits from 3 practitioners
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

2518 Richmond Ave
Houston, TX 77098
Phone (713) 522-2522

Practitioners & affiliated clinicians

Practitioners 3

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": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573084800000",
    "number": "1104976364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2518 RICHMOND AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770983209",
            "telephone_number": "713-522-2522",
            "fax_number": "713-522-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2518 RICHMOND AVE",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770983209",
            "telephone_number": "713-522-2522",
            "fax_number": "713-522-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON VISION GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2019-11-07",
        "status": "A",
        "authorized_official_last_name": "PICKERING",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-995-0042",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PERFECT VISION EYECARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.