Dr. Jason Idiculla O.D. PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

8235TG Issued in TX

Legal business name

DR. JASON IDICULLA O.D. PA

Practice address

3271 Southwest Fwy
Suite a
Houston, TX 77027-7503

Phone

(954) 907-4966

NPI assigned

Nov 24, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Jason Idiculla, O.D.

Title

Optometrist

Phone

(954) 907-4966

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1385251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385251200000",
    "number": "1225468473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 SMITH ST",
            "address_2": "APT. 434",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770028735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3271 SOUTHWEST FWY",
            "address_2": "SUITE A",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770277503",
            "telephone_number": "954-907-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JASON IDICULLA O.D. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-24",
        "last_updated": "2013-11-24",
        "status": "A",
        "authorized_official_last_name": "IDICULLA",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "954-907-4966",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8235TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.