NPIMap

Organization Active NPI

Aeg Texas Professional PLLC

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1114723459
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
AEG TEXAS PROFESSIONAL PLLC
Practice address
10650 Culebra Rd Ste 132
San Antonio, TX 78251-4950
Phone
(210) 523-2020
NPI assigned
Feb 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Authorized official

Name
Melissa Allison
Title
Sr. Director MVC
Phone
(314) 741-8183

Specialties & licenses 1

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

Addresses

Primary practice location

10650 Culebra Rd Ste 132
San Antonio, TX 78251-4950

Mailing address

111 E 4TH St Ste 440
Alton, IL 62002-6206
Phone (314) 741-8183

Other names 1

  • EyeTX - Culebra Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Aeg Texas Professional PLLC31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1114723459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206",
            "telephone_number": "314-741-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10650 CULEBRA RD STE 132",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514950",
            "telephone_number": "210-523-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEG TEXAS PROFESSIONAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "SR. DIRECTOR MVC",
        "authorized_official_telephone_number": "314-741-8183"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EyeTX - Culebra",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.