Carolyn K Kha, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

6592TG Issued in TX

Practice address

4927 Lake Ridge Pkwy
Suite Number 160
Grand Prairie, TX 75052-3073

Phone

(972) 641-5900

Fax

(972) 641-5903

NPI assigned

Aug 19, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• Lake Ridge Eye Care PA

  • Optometrist
  • Grand Prairie, TX
  • NPI 1558450452
  Medicare reassignment NPD Authorized official
• Frisco Eye Associates

  • Optometrist
  • Frisco, TX
  • NPI 1902852346
  NPD (past)

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1114919677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4927 LAKE RIDGE PKWY",
            "address_2": "SUITE NUMBER 160",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523073",
            "telephone_number": "972-641-5900",
            "fax_number": "972-641-5903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4927 LAKE RIDGE PKWY",
            "address_2": "SUITE NUMBER 160",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750523073",
            "telephone_number": "972-641-5900",
            "fax_number": "972-641-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHA",
        "first_name": "CAROLYN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6592TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX OPTOMETRY BOARD",
            "identifier": "6592TG",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS REGISTRATION",
            "identifier": "90136629",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn Keniston, DMD
• Kenpan Hu DMD PA
• Kesha Deshea Thomas LPC, PLLC
• Keturah Health, LLC
• Keystone Psychiatric Case Management Services
• Behrooz Khademazad, DDS
• Waleed Khan, MD
• Geeta Khare
• Cynthia Kidd, OTR
• Kids Can Fly Foundation

• Optometrist in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.