Provident Eye Specialists, PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

PROVIDENT EYE SPECIALISTS, PA

Practice address

11212 Montwood Dr
El Paso, TX 79936-4241

Phone

(915) 595-4300

Fax

(915) 595-4301

NPI assigned

Oct 23, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Keak Chy Khauv, MDNPI 1265444681

Title

Owner

Phone

(915) 240-9198

Specialties & licenses 1

Addresses

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.

• Keak C Khauv, M.D.

  • Ophthalmology Physician
  • El Paso, TX
  • NPI 1265444681
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1558799833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11212 MONTWOOD DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799364241",
            "telephone_number": "915-595-4300",
            "fax_number": "915-595-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11212 MONTWOOD DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799364241",
            "telephone_number": "915-595-4300",
            "fax_number": "915-595-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENT EYE SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-23",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "KHAUV",
        "authorized_official_first_name": "KEAK",
        "authorized_official_middle_name": "CHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-240-9198",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Provencio Enterprises Incorporated
• Mauro Provencio, M.D.
• Tracy Lynn Provenghi, DDS
• Providence Imaging Consultants, P.a.
• Providence Service Corporation
• Jessica Estelle Provine
• Provision Home Care Agency LLC
• Theresa M. Prudencio, OTR
• Yessenia Marie Pruett, LCSW
• Rebecca Pruitt

• Ophthalmology Physician in El Paso, TX
• Providers in El Paso, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.