Individual provider Active NPI

Vanessa Tran Minnick, O.D.

  • Optometrist
  • Cedar Park, TX
National Provider Identifier
1821277161
Registry record updated Dec 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6111 TG Issued in TX
Practice address
2800 E Whitestone Blvd
Suite 210
Cedar Park, TX 78613-7273
Phone
(512) 260-9779
Fax
(512) 260-3703
NPI assigned
Nov 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6111 TG TX Primary
Corneal and Contact Management Optometrist 152WC0802X 6111 TG TX

Addresses

Primary practice location

2800 E Whitestone Blvd
Suite 210
Cedar Park, TX 78613-7273

Mailing address

2800 E Whitestone Blvd
Suite 210
Cedar Park, TX 78613-7273
Phone (512) 260-9779

Other names 1

  • Dr. Vanessa Tran Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040102000072 TX Practitioner - Optometry 1254230097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2800 E Whiteside Blvd
210 Suite 210
Cedar Park, TX 78613-7276
Phone (512) 260-9779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6111TXMDAddiction (Substance Use Disorder) Counselor
6111 TGTXMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fine Eyewear Corneal and Contact Management CurrentSince Oct 16, 2003 Accepting new patients

Locations

2800 E Whitestone Blvd
Ste 210
Cedar Park, TX 78613
Phone (512) 260-9779

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1821277161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E WHITESTONE BLVD",
            "address_2": "SUITE 210",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137273",
            "telephone_number": "512-260-9779",
            "fax_number": "512-260-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E WHITESTONE BLVD",
            "address_2": "SUITE 210",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137273",
            "telephone_number": "512-260-9779",
            "fax_number": "512-260-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNICK",
        "first_name": "VANESSA",
        "middle_name": "TRAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-02",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6111 TG",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "6111 TG",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "TRAN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.