Individual provider Active NPI

Lien Phuong Mai, O.D.

  • Optometrist
  • Pearland, TX
National Provider Identifier
1427033190
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5965 Issued in TX
Practice address
8321 Broadway St
Ste 124
Pearland, TX 77581-5771
Phone
(281) 485-4435
Fax
(281) 485-4033
NPI assigned
Dec 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5965 TX Primary

Addresses

Primary practice location

8321 Broadway St
Ste 124
Pearland, TX 77581-5771

Mailing address

8321 Broadway St
Ste 124
Pearland, TX 77581-5771
Phone (281) 485-4435

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
I20120426000501 TX Order and Referring Only - OptometryPractitioner - Optometry 8224290812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5965TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Etc Optometrist PastSince Mar 26, 2013 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1427033190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8321 BROADWAY ST",
            "address_2": "STE 124",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815771",
            "telephone_number": "281-485-4435",
            "fax_number": "281-485-4033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8321 BROADWAY ST",
            "address_2": "STE 124",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775815771",
            "telephone_number": "281-485-4435",
            "fax_number": "281-485-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAI",
        "first_name": "LIEN",
        "middle_name": "PHUONG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

Verify at the official NPI Registry.