Organization Active NPI

Montgomery Eye Associates PC

  • Optometrist
  • Montgomery, TX
National Provider Identifier
1366977134
Registry record updated Apr 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5751-TG Issued in TX
Legal business name
MONTGOMERY EYE ASSOCIATES PC
Practice address
123 Blue Heron Dr
Suite 103
Montgomery, TX 77316-3192
Phone
(936) 582-2323
NPI assigned
Apr 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2017

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

Authorized official

Name
Dr. Matthew C Snyder, ODNPI 1487650628
Title
Owner
Phone
(936) 582-4200

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: 193400000X SINGLE SPECIALTY GROUP 152W00000X 5751-TG TX Primary

Addresses

Primary practice location

123 Blue Heron Dr
Suite 103
Montgomery, TX 77316-3192

Mailing address

123 Blue Heron Dr
Suite 103
Montgomery, TX 77316-3192

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171120001380 TX Part B Supplier - Clinic/Group Practice 8426315839 Receives reassigned benefits from 1 practitioner
Practice locations: Montgomery, TX

National Provider Directory

National Provider Directory

Locations

123 Blue Heron Dr
Ste 103
Montgomery, TX 77316
Phone (936) 448-4200

Practitioners & affiliated clinicians

Practitioners 1

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": "1493337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493337600000",
    "number": "1366977134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 BLUE HERON DR",
            "address_2": "SUITE 103",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773163192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 BLUE HERON DR",
            "address_2": "SUITE 103",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773163192",
            "telephone_number": "936-582-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY EYE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-28",
        "last_updated": "2017-04-28",
        "status": "A",
        "authorized_official_last_name": "SNYDER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-582-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5751-TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; 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.