Organization Active NPI

Rachel Duran Tellez OD PA

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1962422774
Registry record updated Sep 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
RACHEL DURAN TELLEZ OD PA
Practice address
24165 W Ih 10
Ste 229
San Antonio, TX 78257-1159
Phone
(201) 069-8788
Fax
(210) 698-7886
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2009

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

Authorized official

Name
Rachel D Tellez, O.D.NPI 1720040231
Title
Owner
Phone
(210) 698-7884

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

24165 W Ih 10
Ste 229
San Antonio, TX 78257-1159

Mailing address

24165 W Ih 10
Ste 229
San Antonio, TX 78257-1159
Phone (201) 069-8788

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080819000888 TX Part B Supplier - Clinic/Group Practice 6103991583 Receives reassigned benefits from 2 practitioners
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

24165 Ih 10 W
Ste 125
San Antonio, TX 78257
Phone (210) 698-0610

24165 Ih 10 W
Ste 229
San Antonio, TX 78257
Phone (210) 698-7884

Practitioners & affiliated clinicians

Practitioners 3

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": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253232000000",
    "number": "1962422774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24165 W IH 10",
            "address_2": "STE 229",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571159",
            "telephone_number": "201-069-8788",
            "fax_number": "210-698-7886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24165 W IH 10",
            "address_2": "STE 229",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571159",
            "telephone_number": "201-069-8788",
            "fax_number": "210-698-7886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RACHEL DURAN TELLEZ OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2009-09-18",
        "status": "A",
        "authorized_official_last_name": "TELLEZ",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-698-7884",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 18, 2009; 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.