Individual provider Active NPI

Kandy Luxely Valdovinos, OD

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1336985241
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
11153T Issued in TX
Practice address
434 N Loop 1604 W Ste 3104
San Antonio, TX 78232-1376
Phone
(210) 982-3223
NPI assigned
Jul 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 11153T TX Primary

Addresses

Primary practice location

434 N Loop 1604 W Ste 3104
San Antonio, TX 78232-1376

Mailing address

434 N Loop 1604 W Ste 3104
San Antonio, TX 78232-1376
Phone (210) 463-9124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240717000844 TX Practitioner - Optometry 1254876055 Reassigns benefits to 1 organization
I20251001004324 CA Practitioner - Optometry 1254876055 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gary L Englund OD ApcGroup PAC ID 8628012697, 7 clinicians
Wells and Hile OD an Optometric CorporationGroup PAC ID 9537404983, 4 clinicians

Practice addresses (Care Compare)

1112 Vine St
Paso Robles, CA 93446-5505

1112 Vine St
Suite B
Paso Robles, CA 93446-5506
Phone (805) 238-1001

8105 Morro Rd
Suite a
Atascadero, CA 93422-3911
Phone (805) 466-6939

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36112CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Gary L. Englund, OD, Apc Optometrist CurrentSince Sep 15, 2025 Accepting new patients
Modern Optometry PLLC Optometrist CurrentSince Nov 11, 2024 Accepting new patients
Wells and Hile OD an Optometric Corporation Optometrist CurrentSince Sep 15, 2025 Accepting new patients
Gary L. Englund, OD, Apc Optometrist CurrentSince Sep 15, 2025 Accepting new patients
Lens Masters of Atascadero Inc Optometrist PastSince Jun 11, 2016 Accepting new patients

Locations

8105 Morro Rd
Ste A
Atascadero, CA 93422
Phone (805) 466-6939

2231 Bayview Heights Dr
Los Osos, CA 93402
Phone (805) 528-5333

1112 Vine St
Ste B
Paso Robles, CA 93446
Phone (805) 238-1001

1112 Vine St
Paso Robles, CA 93446
Phone (805) 238-1001

15900 La Cantera Pkwy
Ste 6697
San Antonio, TX 78256
Phone (210) 694-4110

6301 NW Loop 410
Ste 21A
San Antonio, TX 78238
Phone (210) 680-6097

5535 W Loop 1604 N
Ste 104
San Antonio, TX 78253
Phone (210) 415-4230

Organizations & group practices 5

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": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1336985241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 N LOOP 1604 W STE 3104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321376",
            "telephone_number": "210-463-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 N LOOP 1604 W STE 3104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782321376",
            "telephone_number": "210-982-3223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDOVINOS",
        "first_name": "KANDY",
        "middle_name": "LUXELY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "11153T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.