Individual provider Active NPI

Antonio Vasquez, OD

  • Optometrist
  • Los Fresnos, TX
National Provider Identifier
1194746834
Registry record updated May 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6913T Issued in TX
Practice address
810 W Ocean Blvd Ste C2
Los Fresnos, TX 78566-3644
Phone
(956) 233-5252
NPI assigned
Jul 21, 2006
Last updated
May 15, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6913T TX Primary

Addresses

Primary practice location

810 W Ocean Blvd Ste C2
Los Fresnos, TX 78566-3644

Mailing address

6296 Tecate Dr
Brownsville, TX 78521-7185
Phone (832) 816-6510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061030000221 TX Practitioner - Optometry 5294732566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

810 W Ocean Blvd
Los Fresnos, TX 78566-3644
Phone (956) 233-5252

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6913TXMDBehavioral Analyst
6913TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Fresnos Eye Clinic & Optical Inc. Optometrist CurrentSince Jul 1, 2008 Accepting new patients

Locations

810 W Ocean Blvd
Ste C2
Los Fresnos, TX 78566
Phone (956) 233-5252

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1194746834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6296 TECATE DR",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785217185",
            "telephone_number": "832-816-6510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W OCEAN BLVD STE C2",
            "city": "LOS FRESNOS",
            "state": "TX",
            "postal_code": "785663644",
            "telephone_number": "956-233-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6913T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Fresnos, TX

Sources for this page

Verify at the official NPI Registry.