Alliance Retina of Texas, PLLC

Primary specialty

Retina Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0107X

License

Q4189 Issued in TX

Legal business name

ALLIANCE RETINA OF TEXAS, PLLC

Doing business as

Alliance Retina

Practice address

3824 N Tarrant Pkwy Ste 310
Fort Worth, TX 76244-5431

Phone

(817) 617-7678

Fax

(817) 617-7681

NPI assigned

Jan 31, 2017

Last updated

Jul 27, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kim-Binh Thi Mai, MDNPI 1538450721

Title

Ceo

Phone

(817) 617-7678

Specialties & licenses 1

Addresses

Other names 1

• Alliance Retina Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: kbmai@drkimmai.emadirect.md

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kim-Binh Thi Mai, MD

  • Retina Specialist (Ophthalmology) Physician
  • Fort Worth, TX
  • NPI 1538450721
  Medicare reassignment Care Compare group Authorized official
• Keerthana Nagavenkata Bolisetty, MD

  • Retina Specialist (Ophthalmology) Physician
  • Arlington, TX
  • NPI 1407241284
  Medicare reassignment Care Compare group NPD
• Leah Marie Bohnert, OD

  • Optometrist
  • Fort Worth, TX
  • NPI 1467932558
  NPD (past)
• Christopher Cha, OD

  • Optometrist
  • Fort Worth, TX
  • NPI 1871265959
  NPD (past)
• Courtney Nicole Crowell, OD

  • Optometrist
  • Fort Worth, TX
  • NPI 1295468866
  NPD (past)
• Haley Crudgington

  • Optometrist
  • Fort Worth, TX
  • NPI 1346820594
  NPD (past)
• Alisa Khurgin, OD

  • Optometrist
  • Frisco, TX
  • NPI 1750907150
  NPD (past)
• Kenneth Brian King, OD

  • Optometrist
  • Fort Worth, TX
  • NPI 1750469680
  NPD (past)
• Brett H Mueller II, DO, PHD

  • Ophthalmology Physician
  • Fort Worth, TX
  • NPI 1053730077
  NPD (past)
• Joanne Nguyen, OD

  • Optometrist
  • Fort Worth, TX
  • NPI 1710660964
  NPD (past)
• Mark Philip Sherman, M.D.

  • Ophthalmology Physician
  • Lubbock, TX
  • NPI 1720377799
  NPD (past)
• Taylor Boyd Strange, D.O.

  • Ophthalmology Physician
  • Fort Worth, TX
  • NPI 1023336633
  NPD (past)

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595808000000",
    "number": "1346787157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3824 N TARRANT PKWY STE 310",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445431",
            "telephone_number": "817-617-7678",
            "fax_number": "817-617-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3824 N TARRANT PKWY STE 310",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762445431",
            "telephone_number": "817-617-7678",
            "fax_number": "817-617-7681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1007 West Randol Mill Road",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "76012",
            "country_code": "US",
            "telephone_number": "817-715-8024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALLIANCE RETINA OF TEXAS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-31",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "MAI",
        "authorized_official_first_name": "KIM-BINH",
        "authorized_official_middle_name": "THI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-617-7678",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "TX",
            "license": "Q4189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KBMAI@drkimmai.emadirect.md",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3824 N Tarrant Pkwy Ste 310",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762445431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Alliance Retina",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alliance Retina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alliance Network
• Alliance Ophthalmology, PLLC (Alliance Vision Institute)
• Alliance Oral & Maxillofacial Surgery, P.a. (Alliance Oral & Maxillofacial Surgery)
• Alliance Pharmacy LLC (Alliance Pharmacy)
• Alliance Primary Care Assoc PLLC
• Alliance Service Organization
• Alliance Total Wellness, PLLC
• Allied Living Solutions (Pullam&Smith Allied Living Solutions)
• Allison Readinger MD PA (Trinity Vista Dermatology)
• Marcie K Allison

• Retina Specialist (Ophthalmology) Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Retina Specialist (Ophthalmology) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.

Verify at the official NPI Registry.