NPIMap

Organization Active NPI

Seniors Eyecare

  • Optometrist
  • Austin, TX
National Provider Identifier
1619106531
Registry record updated Jul 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
58557 Issued in TX
Legal business name
SENIORS EYECARE
Practice address
16306 E Lake Shore Dr
Austin, TX 78734-1132
Phone
(512) 257-7070
NPI assigned
Jul 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2009

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

Authorized official

Name
Mark Dworsky, O.D.
Title
Doctor
Phone
(512) 257-7070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 58557 TX Primary

Addresses

Primary practice location

16306 E Lake Shore Dr
Austin, TX 78734-1132

Mailing address

16306 E Lake Shore Dr
Austin, TX 78734-1132

Other identifiers 2

IdentifierTypeStateIssuer
1611550MedicaidTX
1123077MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247443200000",
    "number": "1619106531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16306 E LAKE SHORE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787341132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16306 E LAKE SHORE DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787341132",
            "telephone_number": "512-257-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIORS EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-13",
        "last_updated": "2009-07-13",
        "status": "A",
        "authorized_official_last_name": "DWORSKY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "512-257-7070",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "58557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1611550",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1123077",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; 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.