Aeg 3 TX Professional, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

AEG 3 TX PROFESSIONAL, PLLC

Practice address

12400 W Hwy 71 Ste 310
Bee Cave, TX 78738-6504

Phone

(512) 804-2020

Fax

(314) 741-4947

NPI assigned

Jan 19, 2024

Last updated

Jan 19, 2024By 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

Melissa K Allison

Title

Sr. Dir. MVC

Phone

(618) 462-9818

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1851152508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E 4TH ST STE 440",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026206",
            "telephone_number": "618-462-9818",
            "fax_number": "314-741-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12400 W HWY 71 STE 310",
            "city": "BEE CAVE",
            "state": "TX",
            "postal_code": "787386504",
            "telephone_number": "512-804-2020",
            "fax_number": "314-741-4947"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 W Highway 290",
            "address_purpose": "LOCATION",
            "city": "Dripping Springs",
            "state": "TX",
            "postal_code": "786203861",
            "country_code": "US",
            "telephone_number": "512-804-2020",
            "fax_number": "314-741-4947",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5900 W Slaughter Ln Ste 450",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787496513",
            "country_code": "US",
            "telephone_number": "512-288-0090",
            "fax_number": "314-741-4947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AEG 3 TX PROFESSIONAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "ALLISON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SR. DIR. MVC",
        "authorized_official_telephone_number": "618-462-9818"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.