Victoria Family Eyecare, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

05649T Issued in TX

Legal business name

VICTORIA FAMILY EYECARE, PLLC

Practice address

3804 John Stockbauer Dr
Suite a-2
Victoria, TX 77904-2448

Phone

(361) 570-2010

Fax

(361) 570-2012

NPI assigned

Nov 7, 2007

Last updated

Jun 21, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amy D. Henry, O.D.NPI 1770687840

Title

President

Phone

(361) 570-2010

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Tax ID family

Victoria Family Eyecare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Victoria Family Eyecare

  • Optometrist
  • Victoria, TX
  • NPI 1215306626
  NPD tax ID

Locations

Practitioners 2

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.

• Amy Dearixon Henry, OD

  • Optometrist
  • Victoria, TX
  • NPI 1770687840
  Medicare reassignment NPD Authorized official
• Tyler Austin Kvinta, OD

  • Optometrist
  • Friendswood, TX
  • NPI 1902473457
  NPD

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1841470838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3804 JOHN STOCKBAUER DR",
            "address_2": "SUITE A-2",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042448",
            "telephone_number": "361-570-2010",
            "fax_number": "361-570-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 JOHN STOCKBAUER DR",
            "address_2": "SUITE A-2",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779042448",
            "telephone_number": "361-570-2010",
            "fax_number": "361-570-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA FAMILY EYECARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "361-570-2010",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "05649T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS OPTOMETRY LICENSE",
            "identifier": "5649T",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria ENT Associates, LLP
• Victoria Ep PLLC
• Victoria Eye Center PA (Victoria Eye Center)
• Victoria Family Dentistry
• Victoria Family Eyecare
• Victoria Family Medical Clinic PA
• Victoria Foot and Ankle Center, PLLC
• Victoria Hearing Center LLC
• Victoria Heart and Vascular Center, P.a.
• Victoria Hematology & Oncology Associates PA

• Optometrist in Victoria, TX
• Providers in Victoria, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.