Organization Active NPI

San Gabriel Eye Center PLLC

  • Optometrist
  • Georgetown, TX
National Provider Identifier
1851954838
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SAN GABRIEL EYE CENTER PLLC
Practice address
1401 Williams Dr
Georgetown, TX 78628-4115
Phone
(512) 863-2078
Fax
(512) 869-2077
NPI assigned
Apr 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Authorized official

Name
Dr. Jason Carl McCain, ODNPI 1952570400
Title
Owner
Phone
(512) 863-2078

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1401 Williams Dr
Georgetown, TX 78628-4115

Mailing address

1401 Williams Dr
Georgetown, TX 78628-4115
Phone (512) 863-2078

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191209001669 TX Part B Supplier - Clinic/Group Practice 6204269053 Receives reassigned benefits from 5 practitioners
Practice locations: Georgetown, TX

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574726400000",
    "number": "1851954838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 WILLIAMS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786284115",
            "telephone_number": "512-863-2078",
            "fax_number": "512-869-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 WILLIAMS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786284115",
            "telephone_number": "512-863-2078",
            "fax_number": "512-869-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN GABRIEL EYE CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-11-26",
        "status": "A",
        "authorized_official_last_name": "MCCAIN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-863-2078",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.