Lavi Vision PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

7696TG Issued in TX

Legal business name

LAVI VISION PC

Practice address

2325 W Interstate 20
Grand Prairie, TX 75052-3927

Phone

(510) 300-5810

NPI assigned

Mar 21, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Julia N Ta, O.D.NPI 1497808976

Title

Optometrist/President

Phone

(510) 300-5800

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 1

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

• Julia Nguyen Ta, O.D.

  • Optometrist
  • Grand Prairie, TX
  • NPI 1497808976
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332288000000",
    "number": "1558636613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2934 PEGASUS CT",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750528042",
            "telephone_number": "510-300-5810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 W INTERSTATE 20",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523927",
            "telephone_number": "510-300-5810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVI VISION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-21",
        "last_updated": "2012-03-21",
        "status": "A",
        "authorized_official_last_name": "TA",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OPTOMETRIST/PRESIDENT",
        "authorized_official_telephone_number": "510-300-5800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7696TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2871717",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "TXB141982",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.