Organization Active NPI

Custom Eyes of Memorial LLC

  • Optometrist
  • Houston, TX
National Provider Identifier
1366828857
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
CUSTOM EYES OF MEMORIAL LLC
Practice address
8420 Katy Fwy
Suite512
Houston, TX 77024-1941
Phone
(713) 436-6000
Fax
(713) 436-6004
NPI assigned
Aug 6, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Authorized official

Name
Sejal P Patel, OD/OWNER
Title
OD/Owner
Phone
(713) 436-6000

Specialties & licenses 1

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

Addresses

Primary practice location

8420 Katy Fwy
Suite512
Houston, TX 77024-1941

Mailing address

8420 Katy Fwy
Suite512
Houston, TX 77024-1941
Phone (713) 436-6000

National Provider Directory

National Provider Directory

Locations

8420 Katy Fwy
Ste 512
Houston, TX 77024
Phone (713) 436-6000

Practitioners & affiliated clinicians

Practitioners 1

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": "1438819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438819200000",
    "number": "1366828857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8420 KATY FWY",
            "address_2": "SUITE512",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241941",
            "telephone_number": "713-436-6000",
            "fax_number": "713-436-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8420 KATY FWY",
            "address_2": "SUITE512",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241941",
            "telephone_number": "713-436-6000",
            "fax_number": "713-436-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM EYES OF MEMORIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-08-06",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SEJAL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OD/OWNER",
        "authorized_official_telephone_number": "713-436-6000",
        "authorized_official_credential": "OD/OWNER"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 6, 2015; 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.