Killeen Vision 153

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

Legal business name

KILLEEN VISION 153

Practice address

2100 S W S Young Dr Ste 1000
Killeen, TX 76543-5355

Phone

(254) 261-7449

Fax

(254) 261-7450

NPI assigned

May 15, 2023

Last updated

May 15, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

KILLEEN VISION 153As reported in NPPES

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

Authorized official

Name

Taewon KimNPI 1073946406

Title

Optometrist

Phone

(254) 261-7449

Specialties & licenses 1

Addresses

Part of

Killeen Vision 153

Locations

Practitioners 1

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.

• Tae Won Kim, O.D.

  • Optometrist
  • Killeen, TX
  • NPI 1073946406
  NPD Authorized official

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1801586656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 S W S YOUNG DR STE 1000",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765435355",
            "telephone_number": "254-261-7449",
            "fax_number": "254-261-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 S W S YOUNG DR STE 1000",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765435355",
            "telephone_number": "254-261-7449",
            "fax_number": "254-261-7450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 E Central Texas Expy Ste 300",
            "address_purpose": "LOCATION",
            "city": "Harker Heights",
            "state": "TX",
            "postal_code": "765482747",
            "country_code": "US",
            "telephone_number": "254-669-6316",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KILLEEN VISION 153",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KILLEEN VISION 153",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-13",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "TAEWON",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "254-261-7449"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Killeen Modern Dentistry, PC (Killeen Modern Dentistry)
• Killeen Neurology, PA
• Killeen Pediatric Care Clinic, P.a.
• Killeen Pharmacy
• Killeen Surgical Operating Company, LLC (Advanced Surgical Center - Killeen)
• Tae Won Kim, O.D.
• Amanda Rose Kimball
• Dominique Kimble, NP
• Lindsey Grace Julliette Kimbrough, RD/RDN, LD
• Leonard J Kinateder, DDS

• Corneal and Contact Management Optometrist in Killeen, TX
• Providers in Killeen, TX by specialty
• Corneal and Contact Management Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.