Individual provider Active NPI

Theresa Gan Leung, M.D.

  • Ophthalmology Physician
  • Sugar Land, TX
National Provider Identifier
1255597860
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
Q5212 Issued in TX
Practice address
3515 Town Center Blvd S
Sugar Land, TX 77479-1285
Phone
(281) 277-8400
Fax
(281) 277-8408
NPI assigned
Aug 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X D0070675 MD
Ophthalmology Physician 207W00000X Q5212 TX Primary
Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician 207WX0108X Q5212 TX

Addresses

Primary practice location

3515 Town Center Blvd S
Sugar Land, TX 77479-1285

Mailing address

3515 Town Center Blvd S
Sugar Land, TX 77479-1285
Phone (281) 277-8400

Other identifiers 3

IdentifierTypeStateIssuer
358593701MedicaidTX
036176300MedicaidMD
D0070675OtherMDSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0070675MDMDOphthalmology Physician
Q5212TXMDUveitis and Ocular Inflammatory Disease (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Lake Eye Center LLP Past Accepting new patients
Berkeley Eye Institute, PLLC Ophthalmology Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 3

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": "1217721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1255597860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 TOWN CENTER BLVD S",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774791285",
            "telephone_number": "281-277-8400",
            "fax_number": "281-277-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 TOWN CENTER BLVD S",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774791285",
            "telephone_number": "281-277-8400",
            "fax_number": "281-277-8408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUNG",
        "first_name": "THERESA",
        "middle_name": "GAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-03",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0070675",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "Q5212",
            "primary": true
        },
        {
            "code": "207WX0108X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Uveitis and Ocular Inflammatory Disease",
            "state": "TX",
            "license": "Q5212",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "358593701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036176300",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "D0070675",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.