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NPI · 1114438017 · NPPES-sourced

Southlake Vision Group PLLC

ActiveOptometrist
NPI Number
1114438017
Type 2 · Organisation
Taxonomy Code
152W00000X
Contact
(682) 554-2079
Primary practice line
Last Updated
About 8 years ago (Dec 2017)
Enumerated 2017-10-18
Primary practice addressTX · 76092-6618
3004 E Southlake BlvdSouthlake, TX 76092-6618
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About this NPIWhat this record shows.

NPI 1114438017 is registered to Southlake Vision Group PLLC, a healthcare organisation classified as "Optometrist" and located at 3004 E Southlake Blvd in Southlake, Texas. The organisation's authorised official is Yury Ronin. The organisation has been enumerated in the NPI registry since 2017.

Provider type
Organisation (Type 2)
Status
Active
Enumerated
2017-10-18
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Medicare enrollment

This provider holds a Medicare enrollment on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.

Part B Supplier

Source: CMS PECOS public enrollment file.

Insurance & acceptsHow to confirm coverage.

The National Plan and Provider Enumeration System (NPPES) registry does not include commercial insurance network data, so we cannot show which plans Southlake Vision Group PLLC accepts. To confirm in-network status with your specific health plan, contact Southlake Vision Group PLLC directly at (682) 554-2079.

Frequently asked

Yes. NPI 1114438017 is registered as Active in the CMS NPPES public registry and passes the Luhn check-digit validation that all 10-digit NPIs use.

Optometrist is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy.

The CMS NPPES Public Registry at npiregistry.cms.hhs.gov is the authoritative source. FindMyNPI mirrors this dataset and refreshes monthly. For real-time verification, you can also call the provider's office at (682) 554-2079.

An individual healthcare provider has a single Type-1 NPI for life. Organisations can hold separate Type-2 NPIs per location, specialty, or sub-entity. Southlake Vision Group PLLC is a Type-2 organisational NPI.

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Quick facts

Provider typeOrganisation
Taxonomy152W00000X
Last updated2017-12
Enumerated2017-10-18
StatusActive
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