Organization Active NPI

Samuel Gold OD Inc.

  • Optometrist
  • Houston, TX
National Provider Identifier
1366879868
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1671 Issued in TX
Legal business name
SAMUEL GOLD OD INC.
Practice address
711 Shotwell St
Houston, TX 77020-4813
Phone
(713) 673-6550
Fax
(713) 673-6900
NPI assigned
Sep 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

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

Authorized official

Name
Dr. Samuel Gold, O. D.
Title
Optometrist/Owner
Phone
(713) 673-6550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1671 TX Primary

Addresses

Primary practice location

711 Shotwell St
Houston, TX 77020-4813

Mailing address

711 Shotwell St
Houston, TX 77020-4813
Phone (713) 673-6550

Other identifiers 1

IdentifierTypeStateIssuer
09317605985MedicaidTX

Other names 1

  • Texas State Optical Doing business as

National Provider Directory

National Provider Directory

Locations

711 Shotwell St
Houston, TX 77020
Phone (713) 673-6355

Practitioners & affiliated clinicians

Practitioners 2

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": "1380499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449100800000",
    "number": "1366879868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 SHOTWELL ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770204813",
            "telephone_number": "713-673-6550",
            "fax_number": "713-673-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 SHOTWELL ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770204813",
            "telephone_number": "713-673-6550",
            "fax_number": "713-673-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL GOLD OD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-30",
        "last_updated": "2015-12-03",
        "status": "A",
        "authorized_official_last_name": "GOLD",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "713-673-6550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O. D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "1671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09317605985",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas State Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 3, 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.