Individual provider Active NPI

Kerry Thomas Holt, O.D.

  • Optometrist
  • El Paso, TX
National Provider Identifier
1699835637
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5632TG Issued in TX
Practice address
10710 Gateway Blvd N
Ste B-10
El Paso, TX 79924-1739
Phone
(915) 821-6800
Fax
(915) 822-8282
NPI assigned
Dec 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5632TG TX Primary

Addresses

Primary practice location

10710 Gateway Blvd N
Ste B-10
El Paso, TX 79924-1739

Mailing address

10816 Loma de Vida LN
El Paso, TX 79934-3780
Phone (915) 241-2030

Other identifiers 1

IdentifierTypeStateIssuer
81274QOtherTXBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111228000561 TX Practitioner - Optometry 5294921052 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5632TGTXMDOptometrist
5632TXMDPersonal Care Attendant

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Texas Professional PLLC Optometrist CurrentSince Dec 7, 2021 Accepting new patients
Marion Eye Care Center PLLC Optometrist PastSince Apr 10, 2008 Accepting new patients
The Ophthalmology Group, LLC Optometrist PastSince Sep 1, 1998 Accepting new patients
Dianne Bui Dao OD PC Optometrist PastSince Apr 24, 2011 Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients
Pope Enterprises PLLC Optometrist Past Accepting new patients

Locations

3908 Far West Blvd
Austin, TX 78731
Phone (512) 343-0432

12320 Barker Cypress Rd
Ste 400
Cypress, TX 77429
Phone (281) 373-1020

4775 Loma del Sur Dr
El Paso, TX 79934
Phone (512) 889-2020

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

1102 S Friendswood Dr
Ste A
Friendswood, TX 77546
Phone (281) 482-0066

6850 N Shiloh Rd
Ste T
Garland, TX 75044
Phone (972) 414-0444

2705 Broadway St
Ste 115
Pearland, TX 77581
Phone (281) 485-2020

670 E Southlake Blvd
Southlake, TX 76092
Phone (817) 329-6466

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699835637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10816 LOMA DE VIDA LN",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799343780",
            "telephone_number": "915-241-2030",
            "fax_number": "915-822-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10710 GATEWAY BLVD N",
            "address_2": "STE B-10",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799241739",
            "telephone_number": "915-821-6800",
            "fax_number": "915-822-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "KERRY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5632TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "81274Q",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.