Organization Active NPI

Texas Vision Clinic PLLC

  • Optometrist
  • Bastrop, TX
National Provider Identifier
1265949572
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
TEXAS VISION CLINIC PLLC
Practice address
87 Loop 150 W
Bastrop, TX 78602-3930
Phone
(512) 321-2106
NPI assigned
Jan 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Authorized official

Name
Dr. Matthew Philip SchukarNPI 1427490192
Title
Owner
Phone
(512) 321-2106

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 Primary

Addresses

Primary practice location

87 Loop 150 W
Bastrop, TX 78602-3930

Mailing address

87 Loop 150 W
Bastrop, TX 78602-3930
Phone (512) 321-2106

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address matt@txvisionclinic.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180426000027 TX Part B Supplier - Clinic/Group Practice 5193089225 Receives reassigned benefits from 3 practitioners
Practice locations: Bastrop, TX

National Provider Directory

National Provider Directory

Locations

87 Loop 150 W
Bastrop, TX 78602
Phone (512) 321-2106

Practitioners & affiliated clinicians

Practitioners 3

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": "1515369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1265949572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 LOOP 150 W",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786023930",
            "telephone_number": "512-321-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 LOOP 150 W",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786023930",
            "telephone_number": "512-321-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS VISION CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-08",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "SCHUKAR",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "PHILIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-321-2106",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "matt@txvisionclinic.com",
            "affiliation": "N",
            "endpointDescription": "Owner Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "87 Loop 150 W",
            "city": "Bastrop",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786023930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bastrop, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; 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.