Individual provider Active NPI

Anna Hoai Pham

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1003420126
Registry record updated Sep 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10018 Issued in TX
Practice address
120 Empresario Dr Ste 111
San Antonio, TX 78245-4012
Phone
(210) 957-0770
NPI assigned
Sep 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10018 TX Primary

Addresses

Primary practice location

120 Empresario Dr Ste 111
San Antonio, TX 78245-4012

Mailing address

14014 Conner Downs Dr
Pflugerville, TX 78660-8811
Phone (512) 767-8215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210126002737 TX Practitioner - Optometry 9830503242 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Texas Professional PLLC Optometrist CurrentSince Jan 19, 2021 Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients

Locations

211 E Broadway
Alton, IL 62002
Phone (314) 787-0681

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

120 Empresario Dr
Ste 111
San Antonio, TX 78245
Phone (210) 257-0940

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1003420126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14014 CONNER DOWNS DR",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786608811",
            "telephone_number": "512-767-8215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 EMPRESARIO DR STE 111",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782454012",
            "telephone_number": "210-957-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "ANNA",
        "middle_name": "HOAI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.