Victoria Vision Center LLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

VICTORIA VISION CENTER LLC

Practice address

107 James Coleman Dr
Victoria, TX 77904

Phone

(361) 578-0234

Fax

(361) 580-3168

NPI assigned

Jun 4, 2006

Organization subpart

No

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

Authorized official

Name

Debbie Boozalis

Title

Owner

Phone

(361) 578-0234

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Tax ID family

Victoria Vision Center LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Victoria Vision Center LLC

  • Eyewear Supplier
  • Victoria, TX
  • NPI 1467563056
  NPD tax ID
• Victoria Vision Center LLC

  • Eyewear Supplier
  • Victoria, TX
  • NPI 1477664076
  NPD tax ID

Locations

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376438400000",
    "number": "1124067582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 JAMES COLEMAN DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "77904",
            "telephone_number": "361-578-0234",
            "fax_number": "361-580-3168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 JAMES COLEMAN DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "77904",
            "telephone_number": "361-578-0234",
            "fax_number": "361-580-3168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA VISION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2013-08-14",
        "status": "A",
        "authorized_official_last_name": "BOOZALIS",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "361-578-0234"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; 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.