Individual provider Active NPI

Mohsan Ali, OD

  • Optometrist
  • Tyler, TX
National Provider Identifier
1417580713
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9903TG Issued in TX
Practice address
701 W Southwest Loop 323
Tyler, TX 75701-9410
Phone
(903) 534-3882
NPI assigned
Feb 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 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 9903TG TX Primary

Addresses

Primary practice location

701 W Southwest Loop 323
Tyler, TX 75701-9410

Mailing address

701 W Southwest Loop 323
Tyler, TX 75701-9410
Phone (903) 534-3882

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
I20220624000446 TX Practitioner - Optometry 6406235241 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Texas Professional PLLCGroup PAC ID 4486985678, 228 clinicians

Practice addresses (Care Compare)

2705 Broadway St
Suite 115
Pearland, TX 77581-4915
Phone (281) 485-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
9903TGTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optix Vision LLC Optometrist CurrentSince Oct 8, 2025 Accepting new patients
Dianne Bui Dao OD PC Optometrist CurrentSince May 2, 2022 Accepting new patients
Pope Enterprises PLLC Optometrist Past Accepting new patients
Janet B Ogletree OD PA Optometrist PastSince Nov 1, 2016 Accepting new patients
Maxwell a. Olumba, O.D., P.a. Optometrist PastSince Jan 5, 2010 Accepting new patients

Locations

2705 Broadway St
Ste 115
Pearland, TX 77581
Phone (281) 485-2020

701 W Southwest Loop 323
Tyler, TX 75701
Phone (903) 534-3882

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1581724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1417580713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W SOUTHWEST LOOP 323",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019410",
            "telephone_number": "903-534-3882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W SOUTHWEST LOOP 323",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757019410",
            "telephone_number": "903-534-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "MOHSAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-15",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9903TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.