Organization Active NPI

Optical Edge

  • Optometrist
  • Houston, TX
National Provider Identifier
1043606197
Registry record updated Dec 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7262TG Issued in TX
Legal business name
OPTICAL EDGE
Practice address
14870 Space Center Blvd
Suite H
Houston, TX 77062-2368
Phone
(281) 984-7515
Fax
(855) 751-5551
NPI assigned
Apr 15, 2015
Last updated
Dec 7, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2017

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

Authorized official

Name
Regina Thuy Vy Nguyen, ODNPI 1619131869
Title
Owner
Phone
(281) 984-7515

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
Optometrist 152W00000X 7262TG TX Primary

Addresses

Primary practice location

14870 Space Center Blvd
Suite H
Houston, TX 77062-2368

Mailing address

14870 Space Center Blvd
Suite H
Houston, TX 77062-2368

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151118002213 TX Part B Supplier - Clinic/Group Practice 9830499185 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

14870 Space Center Blvd
Ste H
Houston, TX 77062
Phone (281) 984-7515

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512604800000",
    "number": "1043606197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14870 SPACE CENTER BLVD",
            "address_2": "SUITE H",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770622368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14870 SPACE CENTER BLVD",
            "address_2": "SUITE H",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770622368",
            "telephone_number": "281-984-7515",
            "fax_number": "855-751-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL EDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-15",
        "last_updated": "2017-12-07",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "THUY VY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-984-7515",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7262TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.