River City Eyecare

Primary specialty

OptometristTaxonomy code 152W00000X

License

7062T Issued in TX

Legal business name

RIVER CITY EYECARE

Doing business as

Texas State Optical

Practice address

9234 N Loop 1604 W
#104
San Antonio, TX 78249-2983

Phone

(210) 417-4177

Fax

(210) 417-4178

NPI assigned

Sep 3, 2012

Last updated

Nov 5, 2014By 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. Sandra Kay Fortenberry, O.D.

Title

Owner

Phone

(210) 417-4177

Specialties & licenses 15

Addresses

Other names 1

• Texas State Optical Doing business as

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.

• Jeremiah Flower, O.D.

  • Optometrist
  • Helotes, TX
  • NPI 1609320118
  NPD
• Victoria Perez, O.D.

  • Optometrist
  • Alice, TX
  • NPI 1164873667
  NPD
• Gladdis Thomas Page, O.D.

  • Optometrist
  • New Braunfels, TX
  • NPI 1225445158
  NPD (past)
• Benito Pena, O.D

  • Optometrist
  • Kerrville, TX
  • NPI 1497945919
  NPD (past)
• Jason Egbert, O.D.

  • Optometrist
  • Battle Ground, WA
  • NPI 1235528936
  NPD (past)

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

{
    "created_epoch": "1346630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415145600000",
    "number": "1265781553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9234 N LOOP 1604 W",
            "address_2": "#104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492983",
            "telephone_number": "210-417-4177",
            "fax_number": "210-417-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9234 N LOOP 1604 W",
            "address_2": "#104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782492983",
            "telephone_number": "210-417-4177",
            "fax_number": "210-417-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER CITY EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-03",
        "last_updated": "2014-11-05",
        "status": "A",
        "authorized_official_last_name": "FORTENBERRY",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-417-4177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7062T",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "7062T",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "TX",
            "license": "7062T",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "TX",
            "license": "7062T",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "TX",
            "license": "7062T",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "TX",
            "license": "7062T",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "TX",
            "license": "7062T",
            "primary": false
        },
        {
            "code": "156F00000X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist",
            "state": "TX",
            "license": "7062T",
            "primary": false
        },
        {
            "code": "156FC0800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Contact Lens",
            "state": "TX",
            "license": "7062T",
            "primary": false
        },
        {
            "code": "156FC0801X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Contact Lens Fitter",
            "state": "TX",
            "license": "7062T",
            "primary": false
        },
        {
            "code": "156FX1100X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": "TX",
            "license": "7062T",
            "primary": false
        },
        {
            "code": "156FX1101X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ophthalmic Assistant",
            "state": "TX",
            "license": "7062T",
            "primary": false
        },
        {
            "code": "156FX1202X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optometric Technician",
            "state": "TX",
            "license": "7062T",
            "primary": false
        },
        {
            "code": "156FX1700X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ocularist",
            "state": "TX",
            "license": "7062T",
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "TX",
            "license": "7062T",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas State Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• River City Care Center Inc (River City Care Center)
• River City Chiropractic PA
• River City Dental Solutions PLLC
• River City Emergency Physicians, PLLC
• River City Eye Associates PLLC
• River City Home Health, LLC
• River City Hospice of Texas, LLC
• River City Imaging Associates PA
• River City Internal Medicine
• River City Medical Clinic PA

• Optometrist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; 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.