Jeremy Phan, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

10019T Issued in TX

Practice address

16535 Southwest Fwy Ste 230
Sugar Land, TX 77479-2323

Phone

(832) 202-5641

NPI assigned

Nov 20, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

University of Houston - College of Optometry, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Aeg Texas Professional PLLC

  • Optometrist
  • Kerrville, TX
  • NPI 1457905937
  Medicare reassignment Care Compare group NPD
• Jeffrey M. Penn O.D. PA

  • Optometrist
  • Houston, TX
  • NPI 1588814818
  NPD
• Dianne Bui Dao OD PC

  • Optometrist
  • Pearland, TX
  • NPI 1316159346
  NPD (past)
• Janet B Ogletree OD PA

  • Optometrist
  • Flower Mound, TX
  • NPI 1740313089
  NPD (past)
• Pope Enterprises PLLC

  • Optometrist
  • Friendswood, TX
  • NPI 1396927059
  NPD (past)
• Vision Centers of Houston Greenway Galleria PLLC

  • Specialist
  • Houston, TX
  • NPI 1689708919
  NPD (past)

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1093318933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5714 SANTA FE SPRINGS DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770415755",
            "telephone_number": "832-202-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16535 SOUTHWEST FWY STE 230",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774792323",
            "telephone_number": "832-202-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-20",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10019T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tan Pham, D.D.S
• Tien Pham, M.D.
• Trieu Tan Pham, DDS
• Von T. Pham, O.D.
• Charles Gia Phan, M.D.
• Vincent C Phan
• Phanily Eyecare, PA
• Belinda Phares, FNP
• Pharm House Carrizo Springs LLC
• Pharm House Carrizo Springs LLC

• Optometrist in Sugar Land, TX
• Providers in Sugar Land, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.