Organization Active NPI

Eyes Over Texas Eye Care, P.a.

  • Ophthalmology Physician
  • Katy, TX
National Provider Identifier
1376775684
Registry record updated Oct 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
F4680 Issued in TX
Legal business name
EYES OVER TEXAS EYE CARE, P.A.
Practice address
21318 Provincial Blvd
Katy, TX 77450-7580
Phone
(281) 398-0747
Fax
(281) 398-9825
NPI assigned
Aug 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2010

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

Authorized official

Name
Randolph P Whitford, M.D.NPI 1144220104
Title
President
Phone
(281) 398-0747

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X F4680 TX Primary

Addresses

Primary practice location

21318 Provincial Blvd
Katy, TX 77450-7580

Mailing address

21318 Provincial Blvd
Katy, TX 77450-7580
Phone (281) 398-0747

Other identifiers 3

IdentifierTypeStateIssuer
00F84GOtherTXBLUE CROSS BLUE SHIELD
131630903MedicaidTX
180024649OtherTXRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090908000392 TX Part B Supplier - Clinic/Group Practice 4688729015 Receives reassigned benefits from 1 practitioner
Practice locations: Katy, TX

National Provider Directory

National Provider Directory

Locations

21318 Provincial Blvd
Katy, TX 77450
Phone (281) 398-0747

1106 Golfview Dr
Richmond, TX 77469
Phone (281) 344-9191

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": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1376775684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21318 PROVINCIAL BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774507580",
            "telephone_number": "281-398-0747",
            "fax_number": "281-398-9825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21318 PROVINCIAL BLVD",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774507580",
            "telephone_number": "281-398-0747",
            "fax_number": "281-398-9825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYES OVER TEXAS EYE CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "WHITFORD",
        "authorized_official_first_name": "RANDOLPH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-398-0747",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "F4680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00F84G",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131630903",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180024649",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; 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.