Active NPI
Plastic Eye Surgery Associates, PLLC
- Ophthalmic Plastic and Reconstructive Surgery Physician
- Houston, TX
National Provider Identifier
1235222167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmic Plastic and Reconstructive Surgery Physician
- Legal business name
- PLASTIC EYE SURGERY ASSOCIATES, PLLC
- Practice address
- 3730 Kirby Dr
Suite 900
Houston, TX 77098-3905 - Phone
- (713) 795-0705
- Fax
- (713) 807-0630
- NPI assigned
- Oct 2, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Betty L Broussard, MBA
- Title
- Administrator
- Phone
- (713) 795-0705
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmic Plastic and Reconstructive Surgery Physician | 207WX0200X | Primary |
Addresses
Primary practice location
3730 Kirby Dr
Suite 900
Houston, TX 77098-3905
Mailing address
3730 Kirby Dr
Suite 900
Houston, TX 77098-3905
Phone (713) 795-0705
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
128 Vision Park Blvd
Ste 150
Shenandoah, TX 77384
Phone (713) 492-8929
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GCHJCD
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Ophthalmic Plastic and Reconstructive Surgery Physician
- Houston, TX
- NPI 1659464550
-
- Ophthalmic Plastic and Reconstructive Surgery Physician
- Pensacola, FL
- NPI 1932292935
TX
-
- Facial Plastic Surgery Physician
- Shenandoah, TX
- NPI 1073844957
-
- Ophthalmology Physician
- Phoenix, AZ
- NPI 1265537898
-
- Ophthalmology Physician
- Portland, OR
- NPI 1063512101
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1592438400000",
"number": "1235222167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3730 KIRBY DR",
"address_2": "SUITE 900",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770983905",
"telephone_number": "713-795-0705",
"fax_number": "713-807-0630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3730 KIRBY DR",
"address_2": "SUITE 900",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770983905",
"telephone_number": "713-795-0705",
"fax_number": "713-807-0630"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PLASTIC EYE SURGERY ASSOCIATES, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-02",
"last_updated": "2020-06-18",
"certification_date": "2020-06-18",
"status": "A",
"authorized_official_last_name": "BROUSSARD",
"authorized_official_first_name": "BETTY",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "713-795-0705",
"authorized_official_credential": "MBA"
},
"taxonomies": [
{
"code": "207WX0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.