Individual provider Active NPI

Erica Suzanne O'Brien, OD

  • Optometrist
  • Liberty Hill, TX
National Provider Identifier
1922231018
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7416TG Issued in TX
Practice address
14125 W State Highway 29 Ste B202
Liberty Hill, TX 78642-2207
Phone
(737) 707-2155
Fax
(737) 707-2154
NPI assigned
Aug 24, 2009
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7416TG TX Primary

Addresses

Primary practice location

14125 W State Highway 29 Ste B202
Liberty Hill, TX 78642-2207

Mailing address

14125 W State Highway 29 Ste B202
Liberty Hill, TX 78642-2207
Phone (737) 707-2155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230607003247 TX Practitioner - Optometry 6204975956 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vista Family Eye Care PLLCGroup PAC ID 8123485158, 3 clinicians

Practice addresses (Care Compare)

14125 W State Hwy 29
Suite B202
Liberty Hill, TX 78642-2207
Phone (737) 707-2155

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7416TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vista Family Eye Care, PLLC Optometrist CurrentSince May 22, 2023 Accepting new patients

Locations

14125 W State Highway 29
Ste B202
Liberty Hill, TX 78642
Phone (737) 707-2155

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1251072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1922231018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14125 W STATE HIGHWAY 29 STE B202",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786422207",
            "telephone_number": "737-707-2155",
            "fax_number": "737-707-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14125 W STATE HIGHWAY 29 STE B202",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786422207",
            "telephone_number": "737-707-2155",
            "fax_number": "737-707-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "ERICA",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-24",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7416TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty Hill, TX

Sources for this page

Verify at the official NPI Registry.