NPIMap

Organization Active NPI

First Texas Optometric PC

Doing business as EyeTrends-Kingwood

  • Optometrist
  • Kingwood, TX
National Provider Identifier
1609591114
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FIRST TEXAS OPTOMETRIC PC
Doing business as
EyeTrends-Kingwood
Practice address
300 Northpark Dr Ste 600
Kingwood, TX 77339-2696
Phone
(281) 360-1006
NPI assigned
Oct 6, 2022
Last updated
Sep 29, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
FIRST TEXAS OPTOMETRIC PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Authorized official

Name
Steve Jung, ODNPI 1073616983
Title
Owner
Phone
(541) 338-4844

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

300 Northpark Dr Ste 600
Kingwood, TX 77339-2696

Mailing address

3333 Quality Dr
Rancho Cordova, CA 95670-7985
Phone (704) 712-0564

Other names 1

  • EyeTrends-Kingwood Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230731002150 TX Part B Supplier - Clinic/Group Practice 4284095738 Receives reassigned benefits from 34 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Conroe, TX; Kingwood, TX; Spring, TX

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
First Texas Optometric PC4 organizations share this tax ID, including this one
Part of
First Texas Optometric PC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1609591114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 QUALITY DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707985",
            "telephone_number": "704-712-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NORTHPARK DR STE 600",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773392696",
            "telephone_number": "281-360-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST TEXAS OPTOMETRIC PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIRST TEXAS OPTOMETRIC PC",
        "enumeration_date": "2022-10-06",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-338-4844",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EyeTrends-Kingwood",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EyeTrends-Kingwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingwood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.