Organization Active NPI

Wittman Optometry PA

  • Optometrist
  • Lubbock, TX
National Provider Identifier
1235490236
Registry record updated Dec 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5519TG Issued in TX
Legal business name
WITTMAN OPTOMETRY PA
Practice address
10619 Quaker Ave
Lubbock, TX 79424-8309
Phone
(806) 796-5816
NPI assigned
Jun 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2018

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

Authorized official

Name
Cathy Wittman, ODNPI 1023119369
Title
President
Phone
(806) 796-5816

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 5519TG TX Primary
Corneal and Contact Management OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WC0802X 5519TG TX
Low Vision Rehabilitation OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WL0500X 5519TG TX
Pediatric OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WP0200X 5519TG TX
Vision Therapy OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WV0400X 5519TG TX

Addresses

Primary practice location

10619 Quaker Ave
Lubbock, TX 79424-8309

Mailing address

10619 Quaker Ave
Lubbock, TX 79424-8309
Phone (806) 796-5816

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120723000414 TX Part B Supplier - Clinic/Group Practice 1951567809 Receives reassigned benefits from 1 practitioner
Practice locations: Lubbock, TX

National Provider Directory

National Provider Directory

Locations

3410 98th St
Ste 4
Lubbock, TX 79423

8004 Indiana Ave
Ste A2
Lubbock, TX 79423
Phone (806) 796-5816

10619 Quaker Ave
Lubbock, TX 79424
Phone (806) 796-5816

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": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544572800000",
    "number": "1235490236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10619 QUAKER AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794248309",
            "telephone_number": "806-796-5816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10619 QUAKER AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794248309",
            "telephone_number": "806-796-5816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WITTMAN OPTOMETRY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-06",
        "last_updated": "2018-12-12",
        "status": "A",
        "authorized_official_last_name": "WITTMAN",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "806-796-5816",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5519TG",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "5519TG",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "TX",
            "license": "5519TG",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "TX",
            "license": "5519TG",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "TX",
            "license": "5519TG",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2018; 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.