Organization Active NPI

Lovens Crystal Clear Eye Care PLLC

  • Optometrist
  • Waco, TX
National Provider Identifier
1639585938
Registry record updated Jul 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6897TG Issued in TX
Legal business name
LOVENS CRYSTAL CLEAR EYE CARE PLLC
Practice address
600 Hewitt Dr
Waco, TX 76712-6654
Phone
(254) 666-8900
Fax
(254) 666-2888
NPI assigned
Jul 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2014

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

Authorized official

Name
Dr. Travis M Loven, ODNPI 1609074913
Title
Owner
Phone
(254) 666-8900

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 6897TG TX Primary

Addresses

Primary practice location

600 Hewitt Dr
Waco, TX 76712-6654

Mailing address

10008 Adobe CT
Waco, TX 76712-8961
Phone (254) 666-8900

Other identifiers 1

IdentifierTypeStateIssuer
210573602MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141204001444 TX Part B Supplier - Clinic/Group Practice 3476875311 Receives reassigned benefits from 1 practitioner
Practice locations: Waco, TX

National Provider Directory

National Provider Directory

Locations

190 N New Rd
Waco, TX 76710
Phone (254) 399-9979

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": "1404777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404777600000",
    "number": "1639585938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10008 ADOBE CT",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128961",
            "telephone_number": "254-666-8900",
            "fax_number": "254-666-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HEWITT DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767126654",
            "telephone_number": "254-666-8900",
            "fax_number": "254-666-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVENS CRYSTAL CLEAR EYE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-08",
        "last_updated": "2014-07-08",
        "status": "A",
        "authorized_official_last_name": "LOVEN",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-666-8900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6897TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210573602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2014; 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.