Individual provider Active NPI

Tanaka Taylor, O.D.

  • Optometrist
  • Pearland, TX
National Provider Identifier
1326013798
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6108TG Issued in TX
Practice address
10223 Broadway St
Suite J
Pearland, TX 77584-7880
Phone
(281) 971-9337
Fax
(281) 971-9336
NPI assigned
Feb 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6108TG TX Primary

Addresses

Primary practice location

10223 Broadway St
Suite J
Pearland, TX 77584-7880

Mailing address

10223 Broadway St
Suite J
Pearland, TX 77584-7880
Phone (281) 971-9337

Other identifiers 1

IdentifierTypeStateIssuer
11616024OtherCAQH

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
I20070724000081 TX Practitioner - Optometry 5991806770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6108TGTXMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1326013798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10223 BROADWAY ST",
            "address_2": "SUITE J",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847880",
            "telephone_number": "281-971-9337",
            "fax_number": "281-971-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10223 BROADWAY ST",
            "address_2": "SUITE J",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847880",
            "telephone_number": "281-971-9337",
            "fax_number": "281-971-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "TANAKA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6108TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11616024",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.