KJK Eye Care LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

5135TG Issued in TX

Legal business name

KJK EYE CARE LLC

Practice address

510 E Southlake Blvd Ste 100
Southlake, TX 76092-6579

Phone

(817) 481-1665

Fax

(817) 329-7613

NPI assigned

Sep 4, 2007

Organization subpart

No

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

Authorized official

Name

Kim Koogler, BS, CPO

Title

Office Manager

Phone

(817) 481-1665

Specialties & licenses 1

Addresses

Other names 1

• Southlake Family Eye Care 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.

• Kirk Justin Koogler, OD

  • Optometrist
  • Southlake, TX
  • NPI 1255323952
  Medicare reassignment

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656374400000",
    "number": "1194919092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E SOUTHLAKE BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926579",
            "telephone_number": "817-481-1665",
            "fax_number": "817-329-7613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E SOUTHLAKE BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926579",
            "telephone_number": "817-481-1665",
            "fax_number": "817-329-7613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KJK EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-04",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A",
        "authorized_official_last_name": "KOOGLER",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "817-481-1665",
        "authorized_official_credential": "BS, CPO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5135TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southlake Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southlake Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kinsley Consulting LLC
• Andrea Kirby, PSY.D.
• Cameron Danielle Kirby
• Emily Kirby, RBT
• Megan Kirkpatrick, RBT
• Marla Jan Klein
• Samantha Klein, MA, BCBA, LBA
• Donna June Klement, NP-C
• Heather Jo Kline, FNP-C
• Gregory B Kloesel, O.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.