BOERNE VISION CENTER PA (NPI# 1609149731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609149731 |
| Entity Type | Organization |
| Organization Name | BOERNE VISION CENTER PA |
| Practice Address |
124 E Bandera Rd Suite 403 Boerne TX 78006-2849 |
| Practice Telephone | 8303318745 |
| Practice Fax Number | 8303318749 |
| Mailing Telephone | 8303318745 |
| Mailing Fax Number | 8303318749 |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2019-12-09 |
| Authorized Official Name | DR. SUSAN LY JOHNSON (OWNER/AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 8303318745 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 376409401 | 05 |
| Street Address |
124 E BANDERA RD SUITE 403 |
| City | BOERNE |
| State | TX |
| Zip Code | 78006-2849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639179468 | Susan Annette Lee | Family Medicine | 124 E Bandera Rd, Ste. 102, Boerne, TX 78006-2849 | 2005-07-22 |
| 1942613682 | Don Chamberlain | Audiologist | 124 E Bandera Rd, Suite 201, Boerne, TX 78006-2849 | 2014-06-10 |
| 1235571910 | Michael Ryan | Nurse Practitioner | 124 E Bandera Rd, Ste 102, Boerne, TX 78006-2849 | 2013-07-23 |
| 1952686313 | Eye Country, Pllc | Optometrist | 124 E Bandera Rd, Ste 403, Boerne, TX 78006-2849 | 2011-10-18 |
| 1154642551 | Heather Ottmers Caddell | Obstetrics & Gynecology | 124 E Bandera Rd, Suite 204, Boerne, TX 78006-2849 | 2010-06-20 |
| 1134396757 | Rachel Aubrey Gravel | Pediatrics | 124 E Bandera Rd, Suite 304, Boerne, TX 78006-2849 | 2008-05-13 |
| 1861672156 | Diaz Vision Center Pa | Ophthalmology | 124 E Bandera Rd, Suite 404, Boerne, TX 78006-2849 | 2007-11-05 |
| 1447446513 | Barbara A Norvell | Audiologist | 124 E Bandera Rd, Suite 201, Boerne, TX 78006-2849 | 2007-09-21 |
| 1689868648 | Boerne Women's Care, Pllc | Obstetrics & Gynecology | 124 E Bandera Rd, Suite 204, Boerne, TX 78006-2849 | 2007-09-04 |
| 1457401747 | Jennifer L Johnson | Optometrist | 124 E Bandera Rd, Ste 403, Boerne, TX 78006-2849 | 2007-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982218517 | Boerne Mens Clinic | Family Medicine | 138 Tx-46, Boerne, TX 78006 | 2020-09-01 |
| 1700431798 | Methodist Ambulatory Surgery Center of Boerne, LLC | Clinic/Center | 110 Menger Springs, Boerne, TX 78006 | 2019-08-06 |
| 1144704156 | Lauren Elizabeth Settle | Counselor | 26254 Interstate 10, Suite 224, Boerne, TX 78006 | 2018-09-17 |
| 1265914600 | Shana North | Physical Therapy Assistant | 200 Ryan Street, Boerne, TX 78006 | 2018-09-02 |
| 1598258352 | Alamo Prosthetics LLC | Durable Medical Equipment & Medical Supplies | 28711 I 10 W, Boerne, TX 78006 | 2018-06-07 |
| 1578052312 | Premium Pharma, LLC | Pharmacy | 1 Fm 3351 S Ste 115, Boerne, TX 78006 | 2018-05-08 |
| 1952814386 | Advanced Surgical Care of Boerne, LLC | Clinic/Center | 138 Old San Antonio Rd # 400, Boerne, TX 78006 | 2017-11-07 |
| 1184151532 | River Road Pharmacy | Pharmacy | 910 River Rd Ste 103, Boerne, TX 78006 | 2017-05-16 |
| 1487191565 | Olive Branch Hope Center, Inc | Counselor | 215 W Bandera Rd 114 Pmb 239, Boerne, TX 78006 | 2017-01-26 |
| 1063955367 | Leigh Ann Grasso | Pharmacist | 31007 Ih 10 W, Ste 108, Boerne, TX 78006 | 2016-11-18 |
| Find all providers in zip 78006 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841718897 | Johnson Eye Care Pllc | Optometrist | 1375 S Main St Ste 202, Boerne, TX 78006-2844 | 2017-08-30 |
| 1235683889 | Susan Ly Johnson | Optometrist | 124 E Bandera Rd Ste 403, Boerne, TX 78006-2849 | 2016-08-12 |
| 1417352238 | Stephanie N. Kai | Optometrist | 124 E. Bandera Road, Suite 403, Boerne, TX 78006-2849 | 2014-10-23 |
| 1346455011 | Dr. Clyde Singleton Od Pa | Optometrist | 27615 Autumn Terrace, Boerne, TX 78006 | 2007-05-14 |
| 1447273677 | Amy S Ferguson | Optometrist | 104 Medical Dr., Boerne, TX 78006 | 2006-07-26 |
| 1700871373 | Joseph Carlo Arrieta | Optometrist | 125 Rosewood Ave, Boerne, TX 78006-2313 | 2005-09-20 |
| 1194718114 | Justin M Kim | Optometrist | 130 Norris Ln, Boerne, TX 78006-2893 | 2005-08-24 |
| 1952686313 | Eye Country, Pllc | Optometrist | 124 E Bandera Rd, Ste 403, Boerne, TX 78006-2849 | 2011-10-18 |
| 1497049159 | Hindsight 20/20 Eyecare | Optometrist | 104 Medical Dr., Boerne, TX 78006 | 2011-05-30 |
| 1861674111 | Boerne Optical Ltd 1 | Optometrist | 1201 S Main St, Ste 108, Boerne, TX 78006-2833 | 2007-11-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.