NPIMap

Organization Active NPI

Waller Family Eyecare

  • Optometrist
  • Waller, TX
National Provider Identifier
1710172333
Registry record updated Aug 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6241TG Issued in TX
Legal business name
WALLER FAMILY EYECARE
Practice address
31315 FM 2920 Rd
Suite 19
Waller, TX 77484-8049
Phone
(936) 372-3644
Fax
(936) 372-3243
NPI assigned
Sep 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2010

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

Authorized official

Name
Dr. Lindsay Owen, ODNPI 1578677746
Title
Owner/Optometrist
Phone
(936) 372-3644

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 6241TG TX Primary

Addresses

Primary practice location

31315 FM 2920 Rd
Suite 19
Waller, TX 77484-8049

Mailing address

31315 FM 2920 Rd
Suite 19
Waller, TX 77484-8049
Phone (936) 372-3644

Other identifiers 1

IdentifierTypeStateIssuer
173420401MedicaidTX

National Provider Directory

National Provider Directory

Locations

31315 FM 2920 Rd
Ste 18
Waller, TX 77484
Phone (936) 372-3644

Practitioners & affiliated clinicians

Practitioners 4

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": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282521600000",
    "number": "1710172333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31315 FM 2920 RD",
            "address_2": "SUITE 19",
            "city": "WALLER",
            "state": "TX",
            "postal_code": "774848049",
            "telephone_number": "936-372-3644",
            "fax_number": "936-372-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31315 FM 2920 RD",
            "address_2": "SUITE 19",
            "city": "WALLER",
            "state": "TX",
            "postal_code": "774848049",
            "telephone_number": "936-372-3644",
            "fax_number": "936-372-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLER FAMILY EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2010-08-23",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "936-372-3644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6241TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173420401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waller, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; 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.