Organization Active NPI

R Q Optometry

  • Optometrist
  • Pasadena, TX
National Provider Identifier
1902948383
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4593T Issued in TX
Legal business name
R Q OPTOMETRY
Practice address
2777 Shaver St Ste a
Pasadena, TX 77502-4625
Phone
(713) 941-7112
Fax
(713) 941-7112
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Authorized official

Name
Mr. Raul Quintanilla, ODNPI 1578791687
Title
Optometrist Owner
Phone
(713) 941-7112

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 4593T TX Primary

Addresses

Primary practice location

2777 Shaver St Ste a
Pasadena, TX 77502-4625

Mailing address

2777 Shaver St Ste a
Pasadena, TX 77502-4625
Phone (713) 941-7112

Other identifiers 1

IdentifierTypeStateIssuer
019581001MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161103001915 TX Part B Supplier - Clinic/Group Practice 2264710730 Receives reassigned benefits from 1 practitioner
Practice locations: Pasadena, TX

National Provider Directory

National Provider Directory

Locations

2777 Shaver St
Ste A
Pasadena, TX 77502
Phone (713) 941-7112

Practitioners & affiliated clinicians

Practitioners 1

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": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476057600000",
    "number": "1902948383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2777 SHAVER ST STE A",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775024625",
            "telephone_number": "713-941-7112",
            "fax_number": "713-941-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2777 SHAVER ST STE A",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775024625",
            "telephone_number": "713-941-7112",
            "fax_number": "713-941-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R Q OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2016-10-10",
        "status": "A",
        "authorized_official_last_name": "QUINTANILLA",
        "authorized_official_first_name": "RAUL",
        "authorized_official_title_or_position": "OPTOMETRIST OWNER",
        "authorized_official_telephone_number": "713-941-7112",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4593T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019581001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.