Eagle Mountain Family Eye Care, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EAGLE MOUNTAIN FAMILY EYE CARE, PLLC

Practice address

5832 Boat Club Road
Fort Worth, TX 76179-7773

Phone

(817) 237-7153

Fax

(817) 237-7123

NPI assigned

Dec 22, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Miller, OD

Title

Owner

Phone

(817) 237-7153

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1292976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462924800000",
    "number": "1669776225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5832 BOAT CLUB ROAD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761797773",
            "telephone_number": "817-237-7153",
            "fax_number": "817-237-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5832 BOAT CLUB ROAD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761797773",
            "telephone_number": "817-237-7153",
            "fax_number": "817-237-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE MOUNTAIN FAMILY EYE CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-22",
        "last_updated": "2016-05-11",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-237-7153",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; 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.