Organization Active NPI

Bespoke Vision PLLC

  • Optometrist
  • Houston, TX
National Provider Identifier
1992369854
Registry record updated Apr 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BESPOKE VISION PLLC
Practice address
1916 W 18TH St
Houston, TX 77008-1206
Phone
(713) 367-0024
NPI assigned
Apr 25, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2019

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

Authorized official

Name
Kim Mai Nguyen
Title
OD/Owner
Phone
(713) 367-0024

Specialties & licenses 1

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

Addresses

Primary practice location

1916 W 18TH St
Houston, TX 77008-1206

Mailing address

2700 Revere St Apt 144
Houston, TX 77098-1347
Phone (713) 367-0024

National Provider Directory

National Provider Directory

Locations

1916 W 18th St
Houston, TX 77008
Phone (832) 623-6975

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": "1556150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556150400000",
    "number": "1992369854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 REVERE ST APT 144",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770981347",
            "telephone_number": "713-367-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 W 18TH ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770081206",
            "telephone_number": "713-367-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BESPOKE VISION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-25",
        "last_updated": "2019-04-25",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "MAI",
        "authorized_official_title_or_position": "OD/OWNER",
        "authorized_official_telephone_number": "713-367-0024"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.