Individual provider Active NPI

Rido Thi Pham, O.D.

  • Optometrist
  • Tomball, TX
National Provider Identifier
1023318268
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7075T Issued in TX
Practice address
27650 State Highway 249
Tomball, TX 77375-6518
Phone
(281) 516-3937
Fax
(281) 516-3938
NPI assigned
Oct 21, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7075T TX Primary

Addresses

Primary practice location

27650 State Highway 249
Tomball, TX 77375-6518

Mailing address

10322 Knoboak Dr
Houston, TX 77043-2912
Phone (713) 702-8408

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170323000336 TX Practitioner - Ophthalmology 0143505776 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7075TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Tomball Family Eye Care Inc. Optometrist CurrentSince Jan 23, 2013 Accepting new patients

Locations

20310 US Highway 59
New Caney, TX 77357
Phone (281) 306-7099

27650 State Highway 249
Tomball, TX 77375
Phone (281) 351-2144

Organizations & group practices 1

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": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1023318268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10322 KNOBOAK DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770432912",
            "telephone_number": "713-702-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27650 STATE HIGHWAY 249",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773756518",
            "telephone_number": "281-516-3937",
            "fax_number": "281-516-3938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "RIDO",
        "middle_name": "THI",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-21",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7075T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomball, TX

Sources for this page

Verify at the official NPI Registry.