NPIMap

Organization Active NPI

Village Vision Center, PLLC

  • Optometrist
  • Highland Village, TX
National Provider Identifier
1841742558
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VILLAGE VISION CENTER, PLLC
Practice address
2300 Highland Village Rd
Suite 200
Highland Village, TX 75077-7191
Phone
(972) 317-3888
Fax
(972) 317-9872
NPI assigned
Oct 28, 2016
Last updated
Oct 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Authorized official

Name
Dr. Anisha Jacob, ODNPI 1265787998
Title
Owner
Phone
(708) 696-3218

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

2300 Highland Village Rd
Suite 200
Highland Village, TX 75077-7191

Mailing address

2300 Highland Village Rd
Suite 200
Highland Village, TX 75077-7191
Phone (972) 317-3888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170206001018 TX Part B Supplier - Clinic/Group Practice 9133402738 Receives reassigned benefits from 7 practitioners
Practice locations: Highland Village, TX

National Provider Directory

National Provider Directory

Locations

113 Barnett Dr
Lewisville, TX 75077
Phone (972) 317-3888

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1477612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477612800000",
    "number": "1841742558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HIGHLAND VILLAGE RD",
            "address_2": "SUITE 200",
            "city": "HIGHLAND VILLAGE",
            "state": "TX",
            "postal_code": "750777191",
            "telephone_number": "972-317-3888",
            "fax_number": "972-317-9872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HIGHLAND VILLAGE RD",
            "address_2": "SUITE 200",
            "city": "HIGHLAND VILLAGE",
            "state": "TX",
            "postal_code": "750777191",
            "telephone_number": "972-317-3888",
            "fax_number": "972-317-9872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE VISION CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-28",
        "last_updated": "2016-10-28",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "ANISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-696-3218",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Village, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; 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.