Individual provider Active NPI

Annie Williams Houston, OD

  • Optometrist
  • Prosper, TX
National Provider Identifier
1427604933
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9839T Issued in TX
Practice address
3620 W 1St St Ste 60
Prosper, TX 75078-3493
Phone
(469) 715-0775
NPI assigned
Aug 12, 2019
Last updated
Jul 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9839T TX Primary

Addresses

Primary practice location

3620 W 1St St Ste 60
Prosper, TX 75078-3493

Mailing address

PO Box 12
Blue Ridge, TX 75424-0012

Other names 1

  • Annie Williams Other name

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
I20190923000286 TX Practitioner - Optometry 7517241508 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3620 W 1St St
Suite 60
Prosper, TX 75078-3493
Phone (469) 715-0775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9839TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Vision Partners, PLLC. Optometrist CurrentSince May 1, 2024 Accepting new patients
Eyes on Prosper, PLLC Optometrist CurrentSince May 26, 2024 Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince May 31, 2022 Accepting new patients
Med Southwest, PLLC Optometrist Current Accepting new patients
Med Southwest, PLLC Optometrist CurrentSince May 31, 2022 Accepting new patients

Locations

2570 Northshore Blvd
Ste 200
Flower Mound, TX 75028
Phone (972) 539-3900

3032 N Eastman Rd
Ste 100
Longview, TX 75605
Phone (903) 663-2020

3620 W 1st St
Ste 60
Prosper, TX 75078
Phone (469) 715-0775

2703 Richmond Rd
Texarkana, TX 75503
Phone (903) 838-0783

8329 Whitley Rd
Watauga, TX 76148
Phone (817) 431-2020

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

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": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1427604933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "BLUE RIDGE",
            "state": "TX",
            "postal_code": "754240012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 W 1ST ST STE 60",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750783493",
            "telephone_number": "469-715-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSTON",
        "first_name": "ANNIE",
        "middle_name": "WILLIAMS",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9839T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNIE",
            "last_name": "WILLIAMS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Prosper, TX

Sources for this page

Verify at the official NPI Registry.