Organization Active NPI

Potranco Eye Care, PLLC

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1164005922
Registry record updated Sep 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
POTRANCO EYE CARE, PLLC
Practice address
14244 Potranco Rd Ste 450
San Antonio, TX 78253-2133
Phone
(210) 701-8303
NPI assigned
Apr 29, 2021
Last updated
Sep 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2021

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

Authorized official

Name
Peter Nguyen, ODNPI 1326472622
Title
Manager
Phone
(210) 701-8303

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

14244 Potranco Rd Ste 450
San Antonio, TX 78253-2133

Mailing address

14244 Potranco Rd Ste 450
San Antonio, TX 78253-2133
Phone (210) 701-8303

Other practice location 1

10602 Emory Quinn
San Antonio, TX 78254-4589
Phone (832) 640-9780

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230103002818 TX Part B Supplier - Clinic/Group Practice 6406226646 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

14244 Potranco Rd
Ste 450
San Antonio, TX 78253
Phone (210) 701-8303

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1164005922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14244 POTRANCO RD STE 450",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782532133",
            "telephone_number": "210-701-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14244 POTRANCO RD STE 450",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782532133",
            "telephone_number": "210-701-8303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10602 Emory Quinn",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782544589",
            "country_code": "US",
            "telephone_number": "832-640-9780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "POTRANCO EYE CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "210-701-8303",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 29, 2021; 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.