Organization Active NPI

Raul a. Trevino OD PA

Doing business as Vision Source-Castle Hills

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1932246758
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
RAUL A. TREVINO OD PA
Doing business as
Vision Source-Castle Hills
Practice address
2210 NW Military Hwy
San Antonio, TX 78213-1815
Phone
(210) 344-1400
Fax
(210) 342-2039
NPI assigned
Jan 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Authorized official

Name
Eude A Ossorio, CONSULTANTS
Title
Consultant
Phone
(832) 934-1166

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2210 NW Military Hwy
San Antonio, TX 78213-1815

Mailing address

2210 NW Military Hwy
San Antonio, TX 78213-1890
Phone (210) 344-1400

Other names 1

  • VISION SOURCE-CASTLE HILLS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071127000746 TX Part B Supplier - Clinic/Group Practice 9739278862 Receives reassigned benefits from 3 practitioners
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

2112 NW Military Hwy
Ste D
San Antonio, TX 78213
Phone (210) 344-1400

Practitioners & affiliated clinicians

Practitioners 5

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": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1932246758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 NW MILITARY HWY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131890",
            "telephone_number": "210-344-1400",
            "fax_number": "210-342-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 NW MILITARY HWY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131815",
            "telephone_number": "210-344-1400",
            "fax_number": "210-342-2039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAUL A. TREVINO OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "OSSORIO",
        "authorized_official_first_name": "EUDE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CONSULTANT",
        "authorized_official_telephone_number": "832-934-1166",
        "authorized_official_credential": "CONSULTANTS"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VISION SOURCE-CASTLE HILLS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VISION SOURCE-CASTLE HILLS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.