Organization Active NPI

Retina and Vitreous of Texas PLLC

  • Ophthalmology Physician
  • Bellaire, TX
National Provider Identifier
1003892597
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
RETINA AND VITREOUS OF TEXAS PLLC
Practice address
6565 West Loop S Ste 400
Bellaire, TX 77401-3510
Phone
(713) 799-9975
Fax
(713) 799-1095
NPI assigned
Dec 16, 2005
Last updated
Aug 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Authorized official

Name
Joseph A Khawly, MDNPI 1215919998
Title
Ceo
Phone
(713) 799-9975

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

6565 West Loop S Ste 400
Bellaire, TX 77401-3510

Mailing address

6565 West Loop S Ste 400
Bellaire, TX 77401-3510
Phone (713) 799-9975

Other identifiers 1

IdentifierTypeStateIssuer
0950032 02MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040316001295 TX Part B Supplier - Clinic/Group Practice 7911895511 Receives reassigned benefits from 10 practitioners
Practice locations: Webster, TX; Victoria, TX; Tomball, TX; Sugar Land, TX; Pearland, TX; Lufkin, TX; Humble, TX; Conroe, TX…

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2182801Retina and Vitreous of Texas, PLLC6565 West Loop S FL 4, Bellaire, TX 77401Certificate of waiverApr 26, 2028

National Provider Directory

National Provider Directory

Locations

3345 Plaza 10 Dr
Ste B
Beaumont, TX 77707
Phone (409) 833-0009

1205 S Austin St
Brenham, TX 77833
Phone (979) 251-9988

100 Medical Center Blvd
Ste 218
Conroe, TX 77304
Phone (926) 539-2882

2727 Gramercy St
Ste 200
Houston, TX 77025

8588 Katy Fwy
Ste 101
Houston, TX 77024
Phone (713) 467-0990

19747 Highway 59 N
Ste 320
Humble, TX 77338
Phone (281) 548-0095

750 Westgreen Blvd
Ste 250
Katy, TX 77450

1105 W Frank Ave
Ste 300
Lufkin, TX 75904

2734 Sunrise Blvd
Ste 303
Pearland, TX 77584

15200 Southwest Fwy
Ste 292
Sugar Land, TX 77478
Phone (281) 431-5511

15999 City Walk
Ste 290
Sugar Land, TX 77479

455 School St
Ste 47
Tomball, TX 77375
Phone (281) 351-7483

101 W Goodwin Ave
Ste 430
Victoria, TX 77901

920 Clear Lake City Blvd
Ste 200
Webster, TX 77598

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1003892597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6565 WEST LOOP S STE 400",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013510",
            "telephone_number": "713-799-9975",
            "fax_number": "713-799-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 WEST LOOP S STE 400",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013510",
            "telephone_number": "713-799-9975",
            "fax_number": "713-799-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA AND VITREOUS OF TEXAS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-16",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "KHAWLY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "713-799-9975",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0950032 02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellaire, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.