Organization Active NPI

Dreamworks Vision of Prosper PLLC

  • Optometrist
  • Prosper, TX
National Provider Identifier
1497342273
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DREAMWORKS VISION OF PROSPER PLLC
Practice address
4740 W University Dr Ste 180
Prosper, TX 75078-2029
Phone
(469) 476-5100
Fax
(855) 623-3937
NPI assigned
Dec 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Authorized official

Name
Eude A Ossorio, CONSULTANT
Title
Consultant
Phone
(662) 510-2941

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

4740 W University Dr Ste 180
Prosper, TX 75078-2029

Mailing address

4740 W University Dr Ste 180
Prosper, TX 75078-2029
Phone (469) 476-5100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201230000347 TX Part B Supplier - Clinic/Group Practice 6103239603 Receives reassigned benefits from 2 practitioners
Practice locations: Prosper, TX

National Provider Directory

National Provider Directory

Locations

4740 W University Dr
Ste 180
Prosper, TX 75078
Phone (469) 476-5100

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": "1609113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609113600000",
    "number": "1497342273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 W UNIVERSITY DR STE 180",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750782029",
            "telephone_number": "469-476-5100",
            "fax_number": "855-623-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 W UNIVERSITY DR STE 180",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750782029",
            "telephone_number": "469-476-5100",
            "fax_number": "855-623-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREAMWORKS VISION OF PROSPER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-28",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A",
        "authorized_official_last_name": "OSSORIO",
        "authorized_official_first_name": "EUDE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "662-510-2941",
        "authorized_official_credential": "CONSULTANT"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prosper, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; 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.