Amedco Texas LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

AMEDCO TEXAS LLC

Practice address

1101 University Dr E
Ste. 104
College Station, TX 77840-2182

Phone

(979) 260-2500

Fax

(979) 260-2503

NPI assigned

Nov 29, 2011

Organization subpart

No

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

Authorized official

Name

Stephen McCormack

Title

Ceo

Phone

(877) 881-0022

Specialties & licenses 1

Addresses

Other names 1

• International Eye Laser Center Doing business as

Locations

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322524800000",
    "number": "1790052215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8076 W SAHARA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891177930",
            "telephone_number": "877-881-0022",
            "fax_number": "702-255-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 UNIVERSITY DR E",
            "address_2": "STE. 104",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778402182",
            "telephone_number": "979-260-2500",
            "fax_number": "979-260-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMEDCO TEXAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-29",
        "last_updated": "2011-11-29",
        "status": "A",
        "authorized_official_last_name": "MCCORMACK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "877-881-0022"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "International Eye Laser Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nicole Alonzo-Hernadez, PHARMACY INTERN
• Alpha Chiro Sports, LLC
• Alpha Sports McKinney, LLC
• Kellen Dean Alstatt, MD
• Koe Sierra Alvarez, NP
• Dawn Ament, LPC-A
• Veena Anand, M.D.
• Jordyn Brooke Anders
• Margaret Anderson-Brown, MD
• Charles Raymond Anderson, MD

• All providers in College Station, TX
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2011; 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.