Organization Active NPI

Mid County Vision Insights, PLLC

  • Optometrist
  • Nederland, TX
National Provider Identifier
1750617544
Registry record updated Sep 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7245TG Issued in TX
Legal business name
MID COUNTY VISION INSIGHTS, PLLC
Doing business as
Vision Insights
Practice address
3624 Highway 365
Nederland, TX 77627-7835
Phone
(409) 724-7700
Fax
(409) 724-7703
NPI assigned
Oct 28, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2010

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

Authorized official

Name
Dr. Thao Ly Phung, O.D.NPI 1477716827
Title
Doctor of Optometry
Phone
(409) 724-7700

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 7245TG TX Primary

Addresses

Primary practice location

3624 Highway 365
Nederland, TX 77627-7835

Mailing address

3624 Highway 365
Nederland, TX 77627-7835
Phone (409) 724-7700

Other names 1

  • Vision Insights Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100817001385 TX Part B Supplier - Clinic/Group Practice 2466586193 Receives reassigned benefits from 2 practitioners
Practice locations: Port Arthur, TX

National Provider Directory

National Provider Directory

Locations

3624 Highway 365
Nederland, TX 77627
Phone (409) 724-7700

8815 Memorial Blvd
Ste B
Port Arthur, TX 77640
Phone (409) 724-7700

Practitioners & affiliated clinicians

Practitioners 2

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": "1256688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284076800000",
    "number": "1750617544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 HIGHWAY 365",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776277835",
            "telephone_number": "409-724-7700",
            "fax_number": "409-724-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 HIGHWAY 365",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776277835",
            "telephone_number": "409-724-7700",
            "fax_number": "409-724-7703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID COUNTY VISION INSIGHTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-28",
        "last_updated": "2010-09-10",
        "status": "A",
        "authorized_official_last_name": "PHUNG",
        "authorized_official_first_name": "THAO LY",
        "authorized_official_title_or_position": "DOCTOR OF OPTOMETRY",
        "authorized_official_telephone_number": "409-724-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7245TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Insights",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nederland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.