Organization Active NPI

Memorial Vision, P.a.

  • Optometrist
  • Houston, TX
National Provider Identifier
1255517694
Registry record updated Aug 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3476TG Issued in TX
Legal business name
MEMORIAL VISION, P.A.
Practice address
14032B Memorial Dr
Houston, TX 77079-6844
Phone
(281) 496-1635
NPI assigned
Jan 16, 2008
Last updated
Aug 19, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2014

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

Authorized official

Name
Dr. Peggy J Hart, ODNPI 1902807076
Title
President
Phone
(281) 496-1635

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3476TG TX Primary

Addresses

Primary practice location

14032B Memorial Dr
Houston, TX 77079-6844

Mailing address

14032B Memorial Dr
Houston, TX 77079-6844
Phone (281) 496-1635

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050817000218 TX Part B Supplier - Clinic/Group Practice 2668402801 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

14032B Memorial Dr
Houston, TX 77079
Phone (281) 436-1635

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1255517694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14032B MEMORIAL DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770796844",
            "telephone_number": "281-496-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14032B MEMORIAL DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770796844",
            "telephone_number": "281-496-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL VISION, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2014-08-19",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-496-1635",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3476TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.