Organization Active NPI

Rdletwo

  • Optometrist
  • Sugar Land, TX
National Provider Identifier
1063607190
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
04995TG Issued in TX
Legal business name
RDLETWO
Practice address
13879 Southwest Fwy
Sugar Land, TX 77478-3533
Phone
(281) 277-3100
Fax
(281) 277-3115
NPI assigned
Sep 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Robert D. Le, O.D.NPI 1205805397
Title
O.D.
Phone
(281) 277-3100

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 04995TG TX Primary

Addresses

Primary practice location

13879 Southwest Fwy
Sugar Land, TX 77478-3533

Mailing address

13879 Southwest Fwy
Sugar Land, TX 77478-3533
Phone (281) 277-3100

Other identifiers 1

IdentifierTypeStateIssuer
04995TGOtherTXOPTOMETRY LICENSE

Other names 1

  • SUGAR LAND T.S.O. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040805000585 TX Part B Supplier - Clinic/Group Practice 7012988660 Receives reassigned benefits from 1 practitioner
Practice locations: Sugar Land, TX

National Provider Directory

National Provider Directory

Locations

13879 Southwest Fwy
Sugar Land, TX 77478
Phone (281) 277-3100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1063607190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13879 SOUTHWEST FWY",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783533",
            "telephone_number": "281-277-3100",
            "fax_number": "281-277-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13879 SOUTHWEST FWY",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774783533",
            "telephone_number": "281-277-3100",
            "fax_number": "281-277-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RDLETWO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "O.D.",
        "authorized_official_telephone_number": "281-277-3100",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "04995TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY LICENSE",
            "identifier": "04995TG",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUGAR LAND T.S.O.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.