NPIMap

Organization Active NPI

Agnes L Palys OD PC

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1386744332
Registry record updated Apr 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2863TG Issued in TX
Legal business name
AGNES L PALYS OD PC
Practice address
4930 Evers Rd
San Antonio, TX 78228
Phone
(210) 431-0366
Fax
(210) 431-0379
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2015

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

Authorized official

Name
Dr. Agnes Lorraine Palys, OD
Title
President Owner
Phone
(210) 431-0366

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 2863TG TX Primary
Corneal and Contact Management OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WC0802X 3863TG TX
Low Vision Rehabilitation OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WL0500X 2863TG TX

Addresses

Primary practice location

4930 Evers Rd
San Antonio, TX 78228

Mailing address

4930 Evers Rd
San Antonio, TX 78228
Phone (210) 431-0366

Other identifiers 1

IdentifierTypeStateIssuer
019303901MedicaidTX

Other names 1

  • Vision Source Doing business as

National Provider Directory

National Provider Directory

Locations

4930 Evers Rd
San Antonio, TX 78228
Phone (210) 431-0366

1628 Bandera Rd
San Antonio, TX 78228
Phone (210) 431-0366

Practitioners & affiliated clinicians

Practitioners 2

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": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428278400000",
    "number": "1386744332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 EVERS RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78228",
            "telephone_number": "210-431-0366",
            "fax_number": "210-431-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4930 EVERS RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78228",
            "telephone_number": "210-431-0366",
            "fax_number": "210-431-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGNES L PALYS OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2015-04-06",
        "status": "A",
        "authorized_official_last_name": "PALYS",
        "authorized_official_first_name": "AGNES",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "210-431-0366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2863TG",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "3863TG",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "TX",
            "license": "2863TG",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019303901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Source",
            "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 Apr 6, 2015; 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.