NPIMap

Organization Active NPI

Bristol Family Eyecare, PC

  • Optometrist
  • Austin, TX
National Provider Identifier
1649520164
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5613TG Issued in TX
Legal business name
BRISTOL FAMILY EYECARE, PC
Practice address
11500 Bee Caves Rd
Suite 100
Austin, TX 78738-5536
Phone
(512) 263-3937
Fax
(512) 263-3940
NPI assigned
Sep 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Authorized official

Name
Dr. Dan R Bristol, O.D.
Title
Owner
Phone
(512) 263-3937

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 5613TG TX Primary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 7658TG TX

Addresses

Primary practice location

11500 Bee Caves Rd
Suite 100
Austin, TX 78738-5536

Mailing address

11500 Bee Caves Rd
Suite 100
Austin, TX 78738-5536
Phone (512) 263-3937

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121015000474 TX Part B Supplier - Clinic/Group Practice 5294985917 Receives reassigned benefits from 7 practitioners
Practice locations: Austin, TX; Georgetown, TX

National Provider Directory

National Provider Directory

Locations

903 N Austin Ave
Georgetown, TX 78626

3315 Ranch Road 620 S
Ste 150
Lakeway, TX 78738

Practitioners & affiliated clinicians

Practitioners 8

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": "1347408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350000000000",
    "number": "1649520164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 BEE CAVES RD",
            "address_2": "SUITE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787385536",
            "telephone_number": "512-263-3937",
            "fax_number": "512-263-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 BEE CAVES RD",
            "address_2": "SUITE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787385536",
            "telephone_number": "512-263-3937",
            "fax_number": "512-263-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL FAMILY EYECARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-10-12",
        "status": "A",
        "authorized_official_last_name": "BRISTOL",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-263-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5613TG",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7658TG",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Oct 12, 2012; 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.