NPIMap

Organization Active NPI

Lifetime Vision Care PA

  • Optometrist
  • Round Rock, TX
National Provider Identifier
1609969377
Registry record updated Nov 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2584T Issued in TX
Legal business name
LIFETIME VISION CARE PA
Practice address
408 N. Mays St.
Round Rock, TX 78664
Phone
(512) 244-2003
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2008

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

Authorized official

Name
Marc George Bergeron
Title
Owner
Phone
(512) 244-2003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2584T TX Primary

Addresses

Primary practice location

408 N. Mays St.
Round Rock, TX 78664

Mailing address

408 N. Mays St.
Round Rock, TX 78664
Phone (512) 244-2003

National Provider Directory

National Provider Directory

Locations

408 N Mays St
Round Rock, TX 78664
Phone (512) 244-2003

Practitioners & affiliated clinicians

Practitioners 2

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226534400000",
    "number": "1609969377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 N. MAYS ST.",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78664",
            "telephone_number": "512-244-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 N. MAYS ST.",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78664",
            "telephone_number": "512-244-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME VISION CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-11-13",
        "status": "A",
        "authorized_official_last_name": "BERGERON",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-244-2003"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2584T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.