NPIMap

Organization Active NPI

Aeg Texas Professional PLLC

Doing business as Innovative Eyecare

  • Optometrist
  • Austin, TX
National Provider Identifier
1740086008
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
AEG TEXAS PROFESSIONAL PLLC
Doing business as
Innovative Eyecare
Practice address
4301 W William Cannon Dr Ste 210
Austin, TX 78749-1473
Phone
(512) 328-0015
NPI assigned
Feb 19, 2025
Last updated
Feb 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Authorized official

Name
Melissa Allison
Title
Sr. Director MVC
Phone
(314) 741-8183

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

4301 W William Cannon Dr Ste 210
Austin, TX 78749-1473

Mailing address

111 E 4TH St Ste 440
Alton, IL 62002-6206
Phone (314) 741-8183

Other names 1

  • Innovative Eyecare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Aeg Texas Professional PLLC31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

Locations

4301 W William Cannon Dr
Ste 210
Austin, TX 78749
Phone (512) 328-0015

Practitioners & affiliated clinicians

Practitioners 5

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": "1739923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1740086008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206",
            "telephone_number": "314-741-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W WILLIAM CANNON DR STE 210",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787491473",
            "telephone_number": "512-328-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEG TEXAS PROFESSIONAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "SR. DIRECTOR MVC",
        "authorized_official_telephone_number": "314-741-8183"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; 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.