Organization Active NPI

Eyemax Vision PLLC

Doing business as Green Eye Care

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1366212631
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYEMAX VISION PLLC
Doing business as
Green Eye Care
Practice address
10003 NW Military Hwy Ste 3111
San Antonio, TX 78231-1891
Phone
(210) 355-3551
NPI assigned
Jan 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Authorized official

Name
Dr. George Green, ODNPI 1477008274
Title
Manager
Phone
(210) 355-3551

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
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

10003 NW Military Hwy Ste 3111
San Antonio, TX 78231-1891

Mailing address

PO Box 745
Boerne, TX 78006-0745
Phone (210) 355-3551

Other names 1

  • Green Eye Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241203002957 TX Part B Supplier - Clinic/Group Practice 3870028665 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

10003 NW Military Hwy
Ste 3111
San Antonio, TX 78231
Phone (210) 355-3551

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1366212631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 745",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780060745",
            "telephone_number": "210-355-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10003 NW MILITARY HWY STE 3111",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782311891",
            "telephone_number": "210-355-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEMAX VISION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-07",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "210-355-3551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; 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.