NPIMap

Organization Active NPI

Larry Wilkinson

  • Optometrist
  • Rosenberg, TX
National Provider Identifier
1689765414
Registry record updated Jun 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
02165T Issued in TX
Legal business name
LARRY WILKINSON
Practice address
4000 Avenue I
Rosenberg, TX 77471-3904
Phone
(281) 342-4664
Fax
(281) 232-0894
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2015

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

Authorized official

Name
Dr. Larry (Nmi) Wilkinson, O. D.
Title
Owner / Optometrist
Phone
(281) 342-4664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 02165T TX Primary

Addresses

Primary practice location

4000 Avenue I
Rosenberg, TX 77471-3904

Mailing address

4000 Avenue I
P O Box 607
Rosenberg, TX 77471-3904
Phone (281) 342-4664

Other identifiers 1

IdentifierTypeStateIssuer
019274201MedicaidTX

Other names 1

  • Vision Trends Eye Care Doing business as

National Provider Directory

National Provider Directory

Locations

4000 Avenue I
Rosenberg, TX 77471
Phone (281) 342-4664

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": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435276800000",
    "number": "1689765414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 AVENUE I",
            "address_2": "P O BOX 607",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774713904",
            "telephone_number": "281-342-4664",
            "fax_number": "281-232-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 AVENUE I",
            "city": "ROSENBERG",
            "state": "TX",
            "postal_code": "774713904",
            "telephone_number": "281-342-4664",
            "fax_number": "281-232-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY WILKINSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2015-06-26",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "(NMI)",
        "authorized_official_title_or_position": "OWNER / OPTOMETRIST",
        "authorized_official_telephone_number": "281-342-4664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O. D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "02165T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019274201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Trends Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rosenberg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; 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.