Keller Vision Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

KELLER VISION CORPORATION

Practice address

5860 N Tarrant Pkwy
Suite 108 a
Fort Worth, TX 76244-7201

Phone

(817) 766-2090

NPI assigned

Oct 1, 2014

Organization subpart

No

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

Authorized official

Name

Fortsmith Pham

Title

Director

Phone

(817) 766-2090

Specialties & licenses 1

Addresses

Other names 1

• Apex Eye Care Doing business as

Locations

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414627200000",
    "number": "1265835482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5860 N TARRANT PKWY",
            "address_2": "SUITE 108 A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762447201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5860 N TARRANT PKWY",
            "address_2": "SUITE 108 A",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762447201",
            "telephone_number": "817-766-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLER VISION CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-30",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "FORTSMITH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "817-766-2090"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Apex Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shane Kelleher, PA-C
• Steven L. Kellenberger, DC
• Keller Crossing Dentistry PLLC
• Keller Desai Dental PLLC
• Keller Modern Dentistry and Orthodontics, PC
• Payton Keller, DDS
• Robert Tyson Keller, MD
• Robin J Keller, MS, SLP/CCC
• Stewart R Keller, DO
• Susan Keller

• Optometrist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.