KP Eyecare, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

7380T Issued in TX

Legal business name

KP EYECARE, PLLC

Practice address

1819 White Indigo TRL
Round Rock, TX 78665-2818

Phone

(512) 251-8282

Fax

(512) 990-3691

NPI assigned

Nov 18, 2011

Last updated

Nov 18, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kelly P Phan, OD

Title

Optometrist

Phone

(512) 251-8282

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321574400000",
    "number": "1659648699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18700 LIMESTONE COMMERCIAL DR",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786606544",
            "telephone_number": "512-251-8282",
            "fax_number": "512-990-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 WHITE INDIGO TRL",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786652818",
            "telephone_number": "512-251-8282",
            "fax_number": "512-990-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KP EYECARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-18",
        "last_updated": "2011-11-18",
        "status": "A",
        "authorized_official_last_name": "PHAN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "512-251-8282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7380T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; 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.