Individual provider Active NPI

Lanny Shulman, O.D.

  • Optometrist
  • Houston, TX
National Provider Identifier
1114929387
Registry record updated May 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2939T Issued in TX
Practice address
4401 Martin Luther King Blvd.
Houston, TX 77204-2020
Phone
(713) 743-2020
Fax
(713) 743-0963
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2939 TX
Optometrist 152W00000X 2939T TX Primary

Addresses

Primary practice location

4401 Martin Luther King Blvd.
Houston, TX 77204-2020

Mailing address

4401 Martin Luther King Blvd.
Houston, TX 77204-2020
Phone (713) 743-2020

Other identifiers 1

IdentifierTypeStateIssuer
037269002MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2939TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Houston CurrentSince Jan 19, 2014 Accepting new patients
University of Houston System Optometrist CurrentSince Jan 19, 2014 Accepting new patients

Locations

190 Heights Blvd
Houston, TX 77007
Phone (713) 527-8480

505 J Davis Armistead Bldg
Houston, TX 77204
Phone (713) 743-1921

4401 Martin Luther King Blvd
Houston, TX 77204
Phone (713) 743-1921

4901 Calhoun Rd
Rm 2107
Houston, TX 77204
Phone (713) 743-1921

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653609600000",
    "number": "1114929387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 MARTIN LUTHER KING BLVD.",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772042020",
            "telephone_number": "713-743-2020",
            "fax_number": "713-743-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 MARTIN LUTHER KING BLVD.",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772042020",
            "telephone_number": "713-743-2020",
            "fax_number": "713-743-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULMAN",
        "first_name": "LANNY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2939",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2939T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037269002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.