NPIMap

Organization Active NPI

Tso Kingwood North Park PA

  • Optometrist
  • Kingwood, TX
National Provider Identifier
1265867931
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
TSO KINGWOOD NORTH PARK PA
Practice address
25639 US Hwy 59 North
Suite 109
Kingwood, TX 77339
Phone
(832) 934-1166
Fax
(832) 934-1161
NPI assigned
Sep 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Authorized official

Name
Phong Q. Pham, ODNPI 1750636064
Title
Owner/OD
Phone
(832) 934-1166

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

25639 US Hwy 59 North
Suite 109
Kingwood, TX 77339

Mailing address

25639 US Hwy 59 North
Suite 109
Kingwood, TX 77339
Phone (832) 934-1166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140610001506 TX Part B Supplier - Clinic/Group Practice 5193949345 Receives reassigned benefits from 6 practitioners
Practice locations: Kingwood, TX

National Provider Directory

National Provider Directory

Locations

25639 Highway 59 N
Ste 109
Kingwood, TX 77339
Phone (832) 810-2020

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1265867931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25639 US HWY 59 NORTH",
            "address_2": "SUITE 109",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "77339",
            "telephone_number": "832-934-1166",
            "fax_number": "832-934-1161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25639 US HWY 59 NORTH",
            "address_2": "SUITE 109",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "77339",
            "telephone_number": "832-934-1166",
            "fax_number": "832-934-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TSO KINGWOOD NORTH PARK PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-12",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "PHONG",
        "authorized_official_middle_name": "Q.",
        "authorized_official_title_or_position": "OWNER/OD",
        "authorized_official_telephone_number": "832-934-1166",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.

Verify at the official NPI Registry.