Blink Boutique Eyecare & Eyewear PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

BLINK BOUTIQUE EYECARE & EYEWEAR PLLC

Practice address

501 S Austin Ave Unit 1145
Georgetown, TX 78626-5640

Phone

(737) 225-8644

NPI assigned

Jun 28, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Kimberly Q. Pham, ODNPI 1437573235

Title

Co-Owner

Phone

(737) 225-8644

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Q. Pham, O.D

  • Optometrist
  • Georgetown, TX
  • NPI 1437573235
  Medicare reassignment Care Compare group NPD Authorized official
• Alyssa Celeste Garza, OD

  • Optometrist
  • Georgetown, TX
  • NPI 1629637574
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705968000000",
    "number": "1689351082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S AUSTIN AVE UNIT 1145",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786265640",
            "telephone_number": "737-225-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S AUSTIN AVE UNIT 1145",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786265640",
            "telephone_number": "737-225-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLINK BOUTIQUE EYECARE & EYEWEAR PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-28",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "Q.",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "737-225-8644",
        "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 Georgetown, TX
• Providers in Georgetown, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; 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.