Individual provider Active NPI

Ivan Velazquez, OD

  • Optometrist
  • Sugar Land, TX
National Provider Identifier
1144581109
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7811TG Issued in TX
Practice address
18802 University Blvd Ste 155
Sugar Land, TX 77479-6851
Phone
(346) 707-2020
NPI assigned
Jun 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7811TG TX Primary

Addresses

Primary practice location

18802 University Blvd Ste 155
Sugar Land, TX 77479-6851

Mailing address

18802 University Blvd Ste 155
Sugar Land, TX 77479-6851
Phone (346) 707-2020

Other practice location 1

1635-A South Voss
Houston, TX 77057
Phone (713) 954-2020

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
I20121029000573 TX Practitioner - Optometry 0749430734 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Med Southwest PLLCGroup PAC ID 4082952874, 234 clinicians

Practice addresses (Care Compare)

1635 A S Voss Rd
Houston, TX 77057-2622
Phone (847) 677-8022

18802 University Blvd
Suite 155
Sugar Land, TX 77479-6851
Phone (346) 707-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7811TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Med Southwest, PLLC Optometrist CurrentSince Oct 5, 2020 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince Oct 5, 2020 Accepting new patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Iov Eyecare Optometrist CurrentSince Dec 16, 2022 Accepting new patients
Silver Spring Optometry, LLC Optometrist Past Accepting new patients

Locations

1635A S Voss Rd
Houston, TX 77057
Phone (713) 954-2020

6127 FM 1960 Rd W
Houston, TX 77069
Phone (281) 469-2020

18802 University Blvd
Ste 155
Sugar Land, TX 77479
Phone (346) 707-2020

2703 Richmond Rd
Texarkana, TX 75503
Phone (903) 838-0783

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 5

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": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1144581109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18802 UNIVERSITY BLVD STE 155",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774796851",
            "telephone_number": "346-707-2020",
            "fax_number": "346-375-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18802 UNIVERSITY BLVD STE 155",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774796851",
            "telephone_number": "346-707-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1635-A South Voss",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "77057",
            "country_code": "US",
            "telephone_number": "713-954-2020",
            "fax_number": "713-954-2046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-06",
        "last_updated": "2022-12-16",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7811TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.