Individual provider Active NPI

Jessica Watson, OD

  • Optometrist
  • Montgomery, TX
National Provider Identifier
1275375883
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11139T Issued in TX
Practice address
791 Fish Creek Thoroughfare Ste 50
Montgomery, TX 77316-6964
Phone
(936) 362-5462
Fax
(936) 206-7987
NPI assigned
Jun 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11139T TX Primary

Addresses

Primary practice location

791 Fish Creek Thoroughfare Ste 50
Montgomery, TX 77316-6964

Mailing address

791 Fish Creek Thoroughfare Ste 50
Montgomery, TX 77316-6964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240731003717 TX Practitioner - Optometry 8527505122 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2024
Medicare assignment
May accept Medicare assignment
Group practices
Kristynik Eye Care PLLCGroup PAC ID 7012343015, 2 clinicians

Practice addresses (Care Compare)

791 Fish Creek Thoroughfare
Suite 50
Montgomery, TX 77316-6964
Phone (936) 362-5462

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kristynik Eye Care PLLC Optometrist CurrentSince Jul 15, 2025 Accepting new patients

Locations

791 Fish Creek Thoroughfare
Ste 50
Montgomery, TX 77316
Phone (936) 362-5462

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1275375883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "791 FISH CREEK THOROUGHFARE STE 50",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773166964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 FISH CREEK THOROUGHFARE STE 50",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773166964",
            "telephone_number": "936-362-5462",
            "fax_number": "936-206-7987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JESSICA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "11139T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, TX

Sources for this page

Verify at the official NPI Registry.