Eye Country PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

4526TG Issued in TX

Legal business name

EYE COUNTRY PLLC

Practice address

1102 North Llano Street
Suite a
Fredericksburg, TX 78624-5449

Phone

(830) 997-0131

Fax

(866) 897-9855

NPI assigned

Dec 27, 2007

Last updated

Sep 30, 2015By 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

Mrs. Dawn Smith

Title

Office Manager

Phone

(830) 997-0131

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Hans Oosterbaan, OD Former legal business name

Locations

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443571200000",
    "number": "1508040429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 NORTH LLANO STREET",
            "address_2": "SUITE A",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786245449",
            "telephone_number": "830-997-0131",
            "fax_number": "866-897-9855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 NORTH LLANO STREET",
            "address_2": "SUITE A",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786245449",
            "telephone_number": "830-997-0131",
            "fax_number": "866-897-9855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE COUNTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2015-09-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "830-997-0131",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4526TG",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "TX",
            "license": "4526TG",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093435802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hans Oosterbaan, OD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Ericka T McBrine DDS PA
• Carl R. Evans, M.D.
• Emily J Evans, MS, RN, FNP-BC
• Evelyn K Hancock (Brillen Optical)
• George Walton Ewing IV, PHARMD
• Dureshahwar J Fernandez, M.D.
• Andre Jean Ferriere, SLP-CCC
• Angela Fiedler
• Christopher Allen Fincke, M.D.
• Alexander Fischer

• Optometrist in Fredericksburg, TX
• Providers in Fredericksburg, TX by specialty
• Optometrist in Texas

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