Bay Area Optometry Group

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

BAY AREA OPTOMETRY GROUP

Practice address

3457 Clear Lake City Blvd # 500
Houston, TX 77059-2516

Phone

(281) 910-4604

NPI assigned

Jul 26, 2019

Organization subpart

No

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

Authorized official

Name

Joshua Ryan Devera, ODNPI 1477904399

Title

Manager

Phone

(281) 910-4604

Specialties & licenses 1

Addresses

Other names 1

• TSO - Clear Lake Marketplace Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Joshua Ryan Devera, O.D.

  • Optometrist
  • Houston, TX
  • NPI 1477904399
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594857600000",
    "number": "1124672225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6106 TIMBERMOSS CT",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775732592",
            "telephone_number": "281-910-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3457 CLEAR LAKE CITY BLVD # 500",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770592516",
            "telephone_number": "281-910-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA OPTOMETRY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-26",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A",
        "authorized_official_last_name": "DEVERA",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "281-910-4604",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TSO - Clear Lake Marketplace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Houston, TX
• Providers in Houston, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.