Organization Active NPI

Premium Eyecare PLLC

Doing business as Premium Eyecare

  • Optometrist
  • Houston, TX
National Provider Identifier
1699978478
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PREMIUM EYECARE PLLC
Doing business as
Premium Eyecare
Practice address
2402 Bay Area Blvd
Ste. F
Houston, TX 77058-1565
Phone
(281) 488-4774
Fax
(281) 488-4775
NPI assigned
Jun 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael T UkwadeNPI 1174604250
Title
Therapeutic Optometrist
Phone
(281) 488-4774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

2402 Bay Area Blvd
Ste. F
Houston, TX 77058-1565

Mailing address

2402 Bay Area Blvd
Ste. F
Houston, TX 77058-1565
Phone (281) 488-4774

Other identifiers 4

IdentifierTypeStateIssuer
54199OtherDAVIS VISION
26172OtherSPECTERA
0018FEOtherBLUECROSS BLUESHIELD
TX4037OtherEYEMED

Other names 1

  • Premium Eyecare Doing business as

National Provider Directory

National Provider Directory

Locations

2402 Bay Area Blvd
Ste F
Houston, TX 77058
Phone (281) 488-4774

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699978478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 BAY AREA BLVD",
            "address_2": "STE. F",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770581565",
            "telephone_number": "281-488-4774",
            "fax_number": "281-488-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 BAY AREA BLVD",
            "address_2": "STE. F",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770581565",
            "telephone_number": "281-488-4774",
            "fax_number": "281-488-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM EYECARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "UKWADE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "THERAPEUTIC OPTOMETRIST",
        "authorized_official_telephone_number": "281-488-4774",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "54199",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "26172",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "0018FE",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "TX4037",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premium Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.