Organization Active NPI

Vista Family Eye Care, PLLC

  • Optometrist
  • Liberty Hill, TX
National Provider Identifier
1659082436
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VISTA FAMILY EYE CARE, PLLC
Practice address
14125 W State Highway 29 Ste B202
Liberty Hill, TX 78642-2207
Phone
(737) 707-2155
Fax
(737) 707-2154
NPI assigned
Dec 12, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Authorized official

Name
Erica S O'Brien, OD, FCOVDNPI 1922231018
Title
Owner
Phone
(737) 707-2155

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 Primary

Addresses

Primary practice location

14125 W State Highway 29 Ste B202
Liberty Hill, TX 78642-2207

Mailing address

109 Cortona LN
Georgetown, TX 78628-7073
Phone (512) 297-1158

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230607001828 TX Part B Supplier - Clinic/Group Practice 8123485158 Receives reassigned benefits from 3 practitioners
Practice locations: Liberty Hill, TX

National Provider Directory

National Provider Directory

Locations

14125 W State Highway 29
Ste B202
Liberty Hill, TX 78642
Phone (737) 707-2155

Practitioners & affiliated clinicians

Practitioners 3

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": "1670803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670803200000",
    "number": "1659082436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CORTONA LN",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786287073",
            "telephone_number": "512-297-1158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14125 W STATE HIGHWAY 29 STE B202",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786422207",
            "telephone_number": "737-707-2155",
            "fax_number": "737-707-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA FAMILY EYE CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "737-707-2155",
        "authorized_official_credential": "OD, FCOVD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty Hill, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.