NPIMap

Organization Active NPI

Tilley Eye Care Centers LLC

Doing business as Vision Source

  • Optometrist
  • Kerrville, TX
National Provider Identifier
1407929425
Registry record updated Jun 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
TILLEY EYE CARE CENTERS LLC
Doing business as
Vision Source
Practice address
708 Hill Country Dr
Suite 100
Kerrville, TX 78028
Phone
(830) 257-5656
Fax
(830) 257-5856
NPI assigned
Nov 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2018

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

Authorized official

Name
Tobin B Tilley, ODNPI 1215910088
Title
Owner
Phone
(830) 257-5656

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 Primary

Addresses

Primary practice location

708 Hill Country Dr
Suite 100
Kerrville, TX 78028

Mailing address

708 Hill Country Dr
Suite 100
Kerrville, TX 78028-6071
Phone (830) 257-5656

Other identifiers 1

IdentifierTypeStateIssuer
147417301MedicaidTX

Other names 1

  • Vision Source Doing business as

National Provider Directory

National Provider Directory

Locations

708 Hill Country Dr
Ste 10
Kerrville, TX 78028
Phone (830) 257-5656

Practitioners & affiliated clinicians

Practitioners 4

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": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530316800000",
    "number": "1407929425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 HILL COUNTRY DR",
            "address_2": "SUITE 100",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780286071",
            "telephone_number": "830-257-5656",
            "fax_number": "830-257-5856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 HILL COUNTRY DR",
            "address_2": "SUITE 100",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "78028",
            "telephone_number": "830-257-5656",
            "fax_number": "830-257-5856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TILLEY EYE CARE CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2018-06-30",
        "status": "A",
        "authorized_official_last_name": "TILLEY",
        "authorized_official_first_name": "TOBIN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "830-257-5656",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147417301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Source",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vision Source",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kerrville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2018; 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.