NPIMap

Organization Active NPI

Odessa Vision Center PLLC

  • Optometrist
  • Odessa, TX
National Provider Identifier
1578747275
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2713-TG Issued in TX
Legal business name
ODESSA VISION CENTER PLLC
Practice address
4015 Penbrook St
Odessa, TX 79762-5917
Phone
(432) 362-3133
Fax
(432) 362-4818
NPI assigned
Dec 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Authorized official

Name
Justin JackmanNPI 1982046967
Title
President
Phone
(432) 362-3133

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2713-TG TX Primary

Addresses

Primary practice location

4015 Penbrook St
Odessa, TX 79762-5917

Mailing address

4015 Penbrook St
Odessa, TX 79762-5917
Phone (432) 362-3133

Other names 2

  • ODESSA VISION CENTER Doing business as
  • DONALD L HEMBREE OD PC Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mluera@odessavision.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080623000393 TX Part B Supplier - Clinic/Group Practice 0648341446 Receives reassigned benefits from 3 practitioners
Practice locations: Odessa, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1578747275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 PENBROOK ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625917",
            "telephone_number": "432-362-3133",
            "fax_number": "432-362-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 PENBROOK ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797625917",
            "telephone_number": "432-362-3133",
            "fax_number": "432-362-4818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODESSA VISION CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-18",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A",
        "authorized_official_last_name": "JACKMAN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "432-362-3133"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2713-TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mluera@odessavision.com",
            "affiliation": "N",
            "endpointDescription": "Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "varied",
            "address_1": "4015 Penbrook St",
            "city": "Odessa",
            "state": "TX",
            "country_code": "US",
            "postal_code": "797625917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ODESSA VISION CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DONALD L HEMBREE OD PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Odessa, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.