Healthreclaimed Center of Austin, PA

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

K9375 Issued in TX

Legal business name

HEALTHRECLAIMED CENTER OF AUSTIN, PA

Doing business as

BodyLogicMD of Austin

Practice address

3701 Executive Center Dr
Suite 211
Austin, TX 78731-1644

Phone

(512) 672-8797

NPI assigned

Feb 20, 2017

Last updated

Feb 20, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Phyllis Chizomam Okereke, MD

Title

President

Phone

(512) 672-8797

Specialties & licenses 2

Addresses

Other names 1

• BodyLogicMD of Austin Doing business as

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1366981607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 EXECUTIVE CENTER DR",
            "address_2": "211",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787311644",
            "telephone_number": "512-672-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 EXECUTIVE CENTER DR",
            "address_2": "SUITE 211",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787311644",
            "telephone_number": "512-672-8797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHRECLAIMED CENTER OF AUSTIN, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-20",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "OKEREKE",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "CHIZOMAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-672-8797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "TX",
            "license": "K9375",
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "K9375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BodyLogicMD of Austin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ophthalmic Plastic and Reconstructive Surgery Physician in Austin, TX
• Providers in Austin, TX by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.