Kerstin Lorraine Amezcua, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD60801966 Issued in WA

Practice address

1759-1767 Tank Destroyer Blvd
Fort Hood, TX 76544

Phone

(254) 285-6305

NPI assigned

Apr 13, 2016

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 10, 2020.

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1780048017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 BARRINGTON TRL",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765492550",
            "telephone_number": "530-613-6541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1759-1767 TANK DESTROYER BLVD",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "76544",
            "telephone_number": "254-285-6305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMEZCUA",
        "first_name": "KERSTIN",
        "middle_name": "LORRAINE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60801966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• AMC Darnall-Ft Cavazos
• AMC Darnall-Ft Hood
• AMC Darnall-Ft Hood
• AMC Darnall-Ft Hood
• AMC Darnall-Ft Hood
• Cristina Anca Amroian
• Coleman Stokes Anderson, O.D.
• Nancy L Anderson, PHARMACIST
• Marcela Andreotti, DNP, APRN, FNP-C
• Serena Angone

• All providers in Fort Hood, TX
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.