Individual provider Active NPI

Nam-Phong Le, OD

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1194386961
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9701 Issued in TX
Practice address
10722 Potranco Rd Ste 107
San Antonio, TX 78251-3315
Phone
(210) 680-2020
NPI assigned
Jun 24, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9701 TX Primary

Addresses

Primary practice location

10722 Potranco Rd Ste 107
San Antonio, TX 78251-3315

Mailing address

10722 Potranco Rd Ste 107
San Antonio, TX 78251-3315
Phone (832) 483-5947

Other practice location 1

10650 Culebra Rd Ste 132
San Antonio, TX 78251-4950
Phone (210) 523-2020

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
I20210708002402 TX Practitioner - Optometry 9830591106 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Texas Health Science Center at San AntonioGroup PAC ID 0042128548, 1,290 clinicians

Practice addresses (Care Compare)

701 S Zarzamora St
San Antonio, TX 78207-5209
Phone (210) 450-9000

Hospital & facility affiliations

  • Ut Health San Antonio Multispecialty & Research Ho Hospital, San Antonio, TX, CCN 670335
  • University Health System Hospital, San Antonio, TX, CCN 450213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9701TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at San Antonio CurrentSince Mar 14, 2022 Accepting new patients
Aeg Texas Professional PLLC Optometrist CurrentSince Mar 30, 2021 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Mar 14, 2022 Accepting new patients
Steve H. Lai OD PA Optometrist PastSince Aug 6, 2019 Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients

Locations

3551 Justin Rd
Ste 150
Flower Mound, TX 75028
Phone (210) 490-9205

10650 Culebra Rd
Ste 132
San Antonio, TX 78251
Phone (210) 523-2020

701 S Zarzamora St
San Antonio, TX 78207
Phone (210) 358-7000

8300 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-9300

7979 Wurzbach Rd
San Antonio, TX 78229
Phone (210) 450-1000

10722 Potranco Rd
Ste 107
San Antonio, TX 78251
Phone (210) 680-2020

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

Interoperability endpoints

  • Direct secure messaging: nle33851@direct.utmsa.com

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1194386961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10722 POTRANCO RD STE 107",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782513315",
            "telephone_number": "832-483-5947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10722 POTRANCO RD STE 107",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782513315",
            "telephone_number": "210-680-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10650 Culebra Rd Ste 132",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782514950",
            "country_code": "US",
            "telephone_number": "210-523-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "NAM-PHONG",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-24",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.