Individual provider Active NPI

Reza Davoodabadi Farahani, O.D

  • Optometrist
  • Houston, TX
National Provider Identifier
1063419042
Registry record updated Jul 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4643TG Issued in TX
Practice address
5419 FM 1960 Rd W
Suite C
Houston, TX 77069-4305
Phone
(281) 894-2020
Fax
(281) 537-7671
NPI assigned
Jul 5, 2005
Last updated
Jul 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4643TG TX Primary

Addresses

Primary practice location

5419 FM 1960 Rd W
Suite C
Houston, TX 77069-4305

Mailing address

5419 FM 1960 Rd W
Suite C
Houston, TX 77069-4305
Phone (281) 894-2020

Other identifiers 1

IdentifierTypeStateIssuer
129180906MedicaidTX

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
I20100325000238 TX Practitioner - Optometry 5294861654 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 2961732193, 206 clinicians

Practice addresses (Care Compare)

11920 Astoria Blvd
Suite 292
Houston, TX 77089-6155
Phone (713) 486-7970

818 Ringold St
Houston, TX 77088-6368
Phone (281) 448-6391

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.63 of 100Reported as group
Quality
68.75
Promoting interoperability
100
Improvement activities
40
Cost
72.66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4643TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Jun 1, 2021 Accepting new patients
Aeg Texas Professional PLLC Optometrist CurrentSince Dec 1, 2019 Accepting new patients
Clear Lake Eye Center LLP Optometrist Past Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients

Locations

12320 Barker Cypress Rd
Ste 400
Cypress, TX 77429
Phone (281) 373-1020

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

11805 Westheimer Rd
Ste 300
Houston, TX 77077
Phone (281) 496-0689

11920 Astoria Blvd
Ste 292
Houston, TX 77089
Phone (713) 486-7970

6400 Fannin St
Ste 1800
Houston, TX 77030
Phone (713) 486-9400

6411 Fannin St
Fl 7
Houston, TX 77030
Phone (713) 704-1777

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1063419042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5419 FM 1960 RD W",
            "address_2": "SUITE C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770694305",
            "telephone_number": "281-894-2020",
            "fax_number": "281-537-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5419 FM 1960 RD W",
            "address_2": "SUITE C",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770694305",
            "telephone_number": "281-894-2020",
            "fax_number": "281-537-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAHANI",
        "first_name": "REZA",
        "middle_name": "DAVOODABADI",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4643TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129180906",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.