Organization Active NPI

Eyes on Westlake, PLLC

  • Optometrist
  • Westlake, TX
National Provider Identifier
1366098139
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYES ON WESTLAKE, PLLC
Practice address
72 Andorra Dr
Westlake, TX 76262
Phone
(817) 674-7500
NPI assigned
Aug 16, 2019
Last updated
Feb 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Authorized official

Name
Dr. Kimberly Blythe McPherson, ODNPI 1881075927
Title
Owner
Phone
(817) 674-7500

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
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

72 Andorra Dr
Westlake, TX 76262

Mailing address

6113 Pleasant Dream St
North Richland Hills, TX 76180-7425

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201118003135 TX Part B Supplier - Clinic/Group Practice 9739590928 Receives reassigned benefits from 2 practitioners
Practice locations: Westlake, TX

National Provider Directory

National Provider Directory

Locations

72 Andorra Dr
Westlake, TX 76262
Phone (817) 674-7500

72 Andorra Dr
Ste 180
Westlake, TX 76262
Phone (817) 674-7500

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1565913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580947200000",
    "number": "1366098139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6113 PLEASANT DREAM ST",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761807425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 ANDORRA DR",
            "city": "WESTLAKE",
            "state": "TX",
            "postal_code": "76262",
            "telephone_number": "817-674-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYES ON WESTLAKE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-16",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A",
        "authorized_official_last_name": "MCPHERSON",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "BLYTHE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-674-7500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; 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.