Conroe Vision Associates PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

CONROE VISION ASSOCIATES PA

Practice address

1422 N Loop 336 W
Ste. B
Conroe, TX 77304-3540

Phone

(936) 539-2020

Fax

(936) 756-7916

NPI assigned

Feb 4, 2016

Last updated

Oct 24, 2016By 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

David Boeckman, OSNPI 1891767992

Title

Owner/OD

Phone

(936) 539-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David M Boeckman, OD

  • Optometrist
  • Conroe, TX
  • NPI 1891767992
  Medicare reassignment Care Compare group NPD Authorized official
• Warren David Awalt, OD

  • Optometrist
  • Conroe, TX
  • NPI 1578535746
  Medicare reassignment Care Compare group NPD
• Reagan Elizabeth O'Rear, OD

  • Optometrist
  • Conroe, TX
  • NPI 1659484475
  Medicare reassignment Care Compare group NPD
• Lauren A Tom, O.D.

  • Optometrist
  • Conroe, TX
  • NPI 1710174081
  Medicare reassignment Care Compare group NPD
• Bonnie Bloom, OD

  • Optometrist
  • Conroe, TX
  • NPI 1275541815
  Medicare reassignment NPD
• Bailey Kathleen Terhune, OD

  • Optometrist
  • Conroe, TX
  • NPI 1023596160
  Medicare reassignment NPD

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477267200000",
    "number": "1538527692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 N LOOP 336 W",
            "address_2": "STE. B",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043540",
            "telephone_number": "936-539-2020",
            "fax_number": "936-756-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 N LOOP 336 W",
            "address_2": "STE. B",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043540",
            "telephone_number": "936-539-2020",
            "fax_number": "936-756-7916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONROE VISION ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-04",
        "last_updated": "2016-10-24",
        "status": "A",
        "authorized_official_last_name": "BOECKMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/OD",
        "authorized_official_telephone_number": "936-539-2020",
        "authorized_official_credential": "OS"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "3012",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Conroe Vision Associates (Eyeland)
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• Conroe WM LLC (Worthington Manor)
• Conroe-Woodlands Gastroenterology, P.a.
• Adrienne Conroy
• Consider the Lilies Home Care Inc (Consider the Lilies)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.