Individual provider Active NPI

Kimberly H Tham, O.D.

  • Optometrist
  • Pearland, TX
National Provider Identifier
1003891425
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6346T Issued in TX
Practice address
15800 South Fwy
Pearland, TX 77584-1834
Phone
(713) 436-8888
Fax
(713) 436-1960
NPI assigned
Dec 8, 2005
Last updated
Mar 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6346T TX Primary

Addresses

Primary practice location

15800 South Fwy
Pearland, TX 77584-1834

Mailing address

15800 South Fwy
Pearland, TX 77584-1834
Phone (713) 436-8888

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
I20060627000203 TX Practitioner - Optometry 8325050891 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6346TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Texas Professional PLLC Optometrist CurrentSince Feb 10, 2021 Accepting new patients
Dianne Bui Dao OD PC Optometrist CurrentSince Feb 10, 2021 Accepting new patients
Eyedeal Eyecare & Eyewear Optometrist PastSince Mar 2, 2006 Accepting new patients
Eyedentity, P.a. Optometrist Past Accepting new patients

Locations

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

2705 Broadway St
Ste 115
Pearland, TX 77581
Phone (281) 485-2020

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1003891425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15800 SOUTH FWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775841834",
            "telephone_number": "713-436-8888",
            "fax_number": "713-436-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15800 SOUTH FWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775841834",
            "telephone_number": "713-436-8888",
            "fax_number": "713-436-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAM",
        "first_name": "KIMBERLY",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-08",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6346T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.