Organization Active NPI

Whole Vision PA

  • Optometrist
  • Bryan, TX
National Provider Identifier
1336389782
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5179T Issued in TX
Legal business name
WHOLE VISION PA
Practice address
643 N Harvey Mitchell Pkwy
Bryan, TX 77807-1012
Phone
(979) 822-5000
Fax
(979) 822-5002
NPI assigned
Feb 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Authorized official

Name
Judy Hughes, O.D.
Title
President
Phone
(512) 586-3611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 5179T TX Primary

Addresses

Primary practice location

643 N Harvey Mitchell Pkwy
Bryan, TX 77807-1012

Mailing address

4509 Warwick LN
Bryan, TX 77802-5665
Phone (512) 586-3611

Other identifiers 1

IdentifierTypeStateIssuer
2864365-01MedicaidTX

National Provider Directory

National Provider Directory

Locations

13740 Research Blvd
Ste Q4
Austin, TX 78750
Phone (512) 219-1700

NPI Registry JSON

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437091200000",
    "number": "1336389782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4509 WARWICK LN",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025665",
            "telephone_number": "512-586-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "643 N HARVEY MITCHELL PKWY",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778071012",
            "telephone_number": "979-822-5000",
            "fax_number": "979-822-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLE VISION PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-25",
        "last_updated": "2015-07-17",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-586-3611",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5179T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2864365-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.