Organization Active NPI

Maredia Family Eyecare, PLLC

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1194018150
Registry record updated Sep 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MAREDIA FAMILY EYECARE, PLLC
Practice address
1603 Vance Jackson Rd
San Antonio, TX 78213-4470
Phone
(210) 732-3200
Fax
(210) 731-9089
NPI assigned
May 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2018

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

Authorized official

Name
Dr. Nazia N Maredia, O.D.NPI 1417187741
Title
Therapeutic Optometrist
Phone
(281) 773-7262

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1603 Vance Jackson Rd
San Antonio, TX 78213-4470

Mailing address

1603 Vance Jackson Rd
San Antonio, TX 78213-4470
Phone (210) 732-3200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110822000479 TX Part B Supplier - Clinic/Group Practice 5597935999 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2124733Maredia Family Eyecare PLLC1603 Vance Jackson Road, San Antonio, TX 78213Certificate of waiverJan 23, 2027

National Provider Directory

National Provider Directory

Locations

1603 Vance Jackson Rd
San Antonio, TX 78213
Phone (210) 732-3200

Practitioners & affiliated clinicians

Practitioners 1

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": "1306195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536624000000",
    "number": "1194018150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 VANCE JACKSON RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134470",
            "telephone_number": "210-732-3200",
            "fax_number": "210-731-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 VANCE JACKSON RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134470",
            "telephone_number": "210-732-3200",
            "fax_number": "210-731-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAREDIA FAMILY EYECARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-24",
        "last_updated": "2018-09-11",
        "status": "A",
        "authorized_official_last_name": "MAREDIA",
        "authorized_official_first_name": "NAZIA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "THERAPEUTIC OPTOMETRIST",
        "authorized_official_telephone_number": "281-773-7262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "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 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.