Individual provider Active NPI

Shanzida Husain Alam, O.D.

  • Optometrist
  • Houston, TX
National Provider Identifier
1134314222
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7029TG Issued in TX
Practice address
13455 Cutten Rd Ste 1H
Houston, TX 77069-2358
Phone
(281) 469-3400
Fax
(832) 446-3314
NPI assigned
Sep 11, 2007
Last updated
Jul 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7029TG TX Primary

Addresses

Primary practice location

13455 Cutten Rd Ste 1H
Houston, TX 77069-2358

Mailing address

12431 Taylorwood LN
Houston, TX 77070-5130
Phone (281) 610-2058

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180216000192 TX Practitioner - Optometry 6406116227 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7029TXMDChiropractor
7029TGTXMDOptometrist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1134314222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12431 TAYLORWOOD LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770705130",
            "telephone_number": "281-610-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13455 CUTTEN RD STE 1H",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770692358",
            "telephone_number": "281-469-3400",
            "fax_number": "832-446-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAM",
        "first_name": "SHANZIDA",
        "middle_name": "HUSAIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7029TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.