Individual provider Active NPI

Amidemebie Dechavez Casis, B.S., O.D.

  • Optometrist
  • Nacogdoches, TX
National Provider Identifier
1841630936
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8158T Issued in TX
Practice address
3915 NE Stallings Dr
Nacogdoches, TX 75965-2169
Phone
(936) 560-2020
NPI assigned
Jul 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8158T TX Primary

Addresses

Primary practice location

3915 NE Stallings Dr
Nacogdoches, TX 75965-2169

Mailing address

4139S Broadway Ave
Tyler, TX 75701-8720
Phone (903) 534-8349

Other names 1

  • Ami Casis Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Vardeman Eye Associates PLLC Optometrist CurrentSince Jan 10, 2018 Accepting new patients
Dr. Don P Rudasill O. D. Optometrist PastSince Jul 8, 2013 Accepting new patients

Locations

3915 NE Stallings Dr
Nacogdoches, TX 75965
Phone (936) 560-2020

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1841630936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4139S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757018720",
            "telephone_number": "903-534-8349",
            "fax_number": "903-581-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 NE STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759652169",
            "telephone_number": "936-560-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASIS",
        "first_name": "AMIDEMEBIE",
        "middle_name": "DECHAVEZ",
        "name_prefix": "Miss",
        "credential": "B.S., O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8158T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMI",
            "last_name": "CASIS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Nacogdoches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; 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.