Individual provider Active NPI

Gulrez Khoja, O.D.

  • Optometrist
  • Plano, TX
National Provider Identifier
1417206699
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
7403 Issued in TX
Practice address
1700 Coit Rd Ste 100
Plano, TX 75075
Phone
(972) 964-3937
NPI assigned
Sep 5, 2012
Last updated
Feb 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7403 TX Primary

Addresses

Primary practice location

1700 Coit Rd Ste 100
Plano, TX 75075

Mailing address

1700 Coit Rd Ste 100
Plano, TX 75075-6144
Phone (972) 964-3937

Other practice location 1

4104 West 15th Street
Plano, TX 75093
Phone (972) 964-3937

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
I20130130000155 TX Practitioner - Optometry 9739333618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1700 Coit Rd
Suite 100
Plano, TX 75075-6144
Phone (972) 964-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7403TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Vision Inc Optometrist CurrentSince Dec 1, 2012 Accepting new patients

Locations

1700 Coit Rd
Ste 100
Plano, TX 75075
Phone (713) 401-8141

4104 W 15th St
Ste 100
Plano, TX 75093
Phone (972) 964-3937

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1417206699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 COIT RD STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750756144",
            "telephone_number": "972-964-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 COIT RD STE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75075",
            "telephone_number": "972-964-3937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4104 West 15th Street",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "75093",
            "country_code": "US",
            "telephone_number": "972-964-3937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHOJA",
        "first_name": "GULREZ",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.