Waco Vision Center, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

8143TG Issued in TX

Legal business name

WACO VISION CENTER, PLLC

Practice address

5201 Bosque Blvd
#220
Waco, TX 76710-4676

Phone

(254) 741-1022

Fax

(254) 776-1053

NPI assigned

Dec 22, 2015

Last updated

Nov 7, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Long DO, O.D.NPI 1154763340

Title

Optometrist

Phone

(817) 262-2145

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Long DO, O.D.

  • Optometrist
  • Waco, TX
  • NPI 1154763340
  Medicare reassignment NPD Authorized official
• Lou Henry Martinez, OD

  • Optometrist
  • Waco, TX
  • NPI 1447825914
  Medicare reassignment NPD
• Damaris Williamson, O.D.

  • Optometrist
  • Waco, TX
  • NPI 1154772754
  NPD
• Henry Lee Phillips, O.D.

  • Optometrist
  • Waco, TX
  • NPI 1780806703
  NPD (past)
• Robert Michael Prince, O.D.

  • Pediatric Optometrist
  • Huntsville, TX
  • NPI 1821006164
  NPD (past)

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

{
    "created_epoch": "1450742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1245695972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5836 SUNNY MEADOW LN",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750528782",
            "telephone_number": "817-262-2145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 BOSQUE BLVD",
            "address_2": "#220",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104676",
            "telephone_number": "254-741-1022",
            "fax_number": "254-776-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACO VISION CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-22",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "LONG",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "817-262-2145",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8143TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Waco SN Opco LLC (Alpha Skilled Nursing & Rehab)
• Waco SNF LLC (Wesley Woods Health & Rehabilitation)
• Waco Surgical Center LTD
• Waco Surgical Clinic P a
• Waco Texas Emergency Center LLC
• Waco Works Occupational Medicine, PLLC
• Waco Wound Care, PLLC
• Jasmine Wafer, RBT
• Jeanne Duncan Waggener, RPH
• Thomas Wilson Waggener, D.D.S.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.