Crystal Falls Vision Center, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

6940TG Issued in TX

Legal business name

CRYSTAL FALLS VISION CENTER, PLLC

Doing business as

Crystal Falls Vision Center

Practice address

3550 Lakeline Blvd
Ste 180
Leander, TX 78641

Phone

(281) 235-3589

NPI assigned

Oct 24, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Bradly Mathew, O.D.NPI 1770606899

Title

Optometrist/Owner

Phone

(281) 235-3589

Specialties & licenses 1

Addresses

Other names 1

• Crystal Falls Vision Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Bradly Greg Mathew, O.D

  • Optometrist
  • Leander, TX
  • NPI 1770606899
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1962807586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3807 SEBASTIAN CV",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786812332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 LAKELINE BLVD",
            "address_2": "STE 180",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "78641",
            "telephone_number": "281-235-3589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL FALLS VISION CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "MATHEW",
        "authorized_official_first_name": "BRADLY",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "281-235-3589",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6940TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crystal Falls Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Leander, TX
• Providers in Leander, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; 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.