Visionary Eyecare Center LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

9206TG Issued in TX

Legal business name

VISIONARY EYECARE CENTER LLC

Practice address

1217 Oak Knoll Dr
Fort Worth, TX 76117-5505

Phone

(817) 932-2498

NPI assigned

Nov 18, 2017

Last updated

Jan 9, 2018By 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. Alisha Poonawala, ODNPI 1649719212

Title

Optometrist

Phone

(817) 932-2498

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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.

• Alisha Poonawala, O.D.

  • Optometrist
  • Fort Worth, TX
  • NPI 1649719212
  Medicare reassignment Authorized official
• Leonard R. Pack, O.D.

  • Optometrist
  • Fort Worth, TX
  • NPI 1568573574
  NPD (past)

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

{
    "created_epoch": "1510963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515456000000",
    "number": "1326552985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1342 WOODBROOK CT",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760924835",
            "telephone_number": "817-932-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 OAK KNOLL DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761175505",
            "telephone_number": "817-932-2498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISIONARY EYECARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-18",
        "last_updated": "2018-01-09",
        "status": "A",
        "authorized_official_last_name": "POONAWALA",
        "authorized_official_first_name": "ALISHA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "817-932-2498",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9206TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virtue Healthcare PLLC
• Virtue of Hope Healthcare Services
• Laci Christine Vise
• Vishnu K Rumalla, M.D.
• Vision Care Pro PLLC
• Visioncare Group at West 7TH, P.a.
• Visionworks, Inc. (Visionworks)
• Visionworks, Inc. (Visionworks)
• Visionworks, Inc.
• Visionworks, Inc. (Visionworks)

• 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 Jan 9, 2018; 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.