Target Independent Doctor of Optometry

Primary specialty

OptometristTaxonomy code 152W00000X

License

7380T Issued in TX

Legal business name

TARGET INDEPENDENT DOCTOR OF OPTOMETRY

Practice address

18700 Limestone Commercial Dr
Pflugerville, TX 78660-6544

Phone

(512) 990-1440

Fax

(512) 990-3691

NPI assigned

Jul 7, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Kelly Phuong Phan, O.D.NPI 1760611248

Title

Optometrist

Phone

(405) 761-2872

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly Phuong Phan, O.D.

  • Optometrist
  • Pflugerville, TX
  • NPI 1760611248
  NPD (past) Authorized official

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246924800000",
    "number": "1508095092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 CONCORD DR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651314",
            "telephone_number": "405-761-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18700 LIMESTONE COMMERCIAL DR",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786606544",
            "telephone_number": "512-990-1440",
            "fax_number": "512-990-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARGET INDEPENDENT DOCTOR OF OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-07",
        "last_updated": "2009-07-07",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "PHUONG",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "405-761-2872",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7380T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Swish Dental Pfluggerville, PC
• Melissa Switzer, LCSW
• Sylvia Inameti
• Takecare Integrative Psychiatry & Wellness
• Chanveen Taneja, LPC
• Bonner Taylor
• Jane Taylor
• Mary Catherine Taylor, RPH
• TCH Pediatric Associates, Inc.
• Madison Terbush

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2009; 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.