Organization Active NPI

RGV Vision Care LLC

  • Optometrist
  • Weslaco, TX
National Provider Identifier
1154813129
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5749 Issued in TX
Legal business name
RGV VISION CARE LLC
Practice address
415 S Airport Dr Ste H
Weslaco, TX 78596-5396
Phone
(956) 447-2020
Fax
(956) 969-0459
NPI assigned
Jun 5, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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

Authorized official

Name
Jaime Roderiguez, OD
Title
Owner
Phone
(956) 447-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 5749 TX Primary

Addresses

Primary practice location

415 S Airport Dr Ste H
Weslaco, TX 78596-5396

Mailing address

415 S Airport Dr Ste H
Weslaco, TX 78596-5396
Phone (956) 447-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180628000865 TX Part B Supplier - Clinic/Group Practice 6507112885 Receives reassigned benefits from 2 practitioners
Practice locations: San Benito, TX; Weslaco, TX

National Provider Directory

National Provider Directory

Locations

801 N Sam Houston Blvd
San Benito, TX 78586
Phone (956) 361-7600

Practitioners & affiliated clinicians

Practitioners 5

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": "1528156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528156800000",
    "number": "1154813129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S AIRPORT DR STE H",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "785965396",
            "telephone_number": "956-447-2020",
            "fax_number": "956-969-0459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S AIRPORT DR STE H",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "785965396",
            "telephone_number": "956-447-2020",
            "fax_number": "956-969-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RGV VISION CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-06-05",
        "status": "A",
        "authorized_official_last_name": "RODERIGUEZ",
        "authorized_official_first_name": "JAIME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-447-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weslaco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; 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.