Active NPI
Haotam Thuy Phan, OD
- Optometrist
- Houston, TX
National Provider Identifier
1275542425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 6247TG
- Practice address
- 9555A South Post Oak Rd.
Houston, TX 77096 - Phone
- (713) 728-3937
- Fax
- (713) 728-3939
- NPI assigned
- Aug 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 6247TG | TX | Primary |
Addresses
Primary practice location
9555A South Post Oak Rd.
Houston, TX 77096
Mailing address
5846 New Territory Blvd
Sugar Land, TX 77479-5948
Phone (281) 242-2946
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 169663501 | Medicaid | TX |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6247TG | TX | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213142400000",
"number": "1275542425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5846 NEW TERRITORY BLVD",
"city": "SUGAR LAND",
"state": "TX",
"postal_code": "774795948",
"telephone_number": "281-242-2946",
"fax_number": "281-242-2947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9555A SOUTH POST OAK RD.",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77096",
"telephone_number": "713-728-3937",
"fax_number": "713-728-3939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "HAOTAM",
"middle_name": "THUY",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-05",
"last_updated": "2008-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "6247TG",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "169663501",
"state": "TX"
}
],
"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 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.