NPIMap

Organization Active NPI

Willowbrook Tso PC

Doing business as Willowbrook Texas State Optical

  • Optometrist
  • Houston, TX
National Provider Identifier
1073582466
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WILLOWBROOK TSO PC
Doing business as
Willowbrook Texas State Optical
Practice address
17776 Tomball Pkwy
Suite #15
Houston, TX 77064-1016
Phone
(281) 890-8480
NPI assigned
Mar 16, 2006
Last updated
Jul 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

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

Authorized official

Name
Thomas Ford
Title
Director
Phone
(713) 412-7842

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

17776 Tomball Pkwy
Suite #15
Houston, TX 77064-1016

Mailing address

1250 Uvalde Rd
Houston, TX 77015-3708

Other identifiers 1

IdentifierTypeStateIssuer
1573727-01MedicaidTX

Other names 1

  • Willowbrook Texas State Optical Doing business as

National Provider Directory

National Provider Directory

Locations

17776 Tomball Pkwy
Ste 15
Houston, TX 77064
Phone (281) 890-8480

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405382400000",
    "number": "1073582466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 UVALDE RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770153708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17776 TOMBALL PKWY",
            "address_2": "SUITE #15",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770641016",
            "telephone_number": "281-890-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOWBROOK TSO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-16",
        "last_updated": "2014-07-15",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "713-412-7842"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1573727-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willowbrook Texas State Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.