Individual provider Active NPI

Tawnya Alayna Pham, OD

  • Optometrist
  • The Woodlands, TX
National Provider Identifier
1487387767
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10680 Issued in TX
Practice address
9595 Six Pines Dr Ste 1350a
The Woodlands, TX 77380-1531
Phone
(281) 298-3755
NPI assigned
Jul 5, 2022
Last updated
Aug 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10680 TX Primary

Addresses

Primary practice location

9595 Six Pines Dr Ste 1350a
The Woodlands, TX 77380-1531

Mailing address

1821 W Chateau Ave
Anaheim, CA 92804-4505
Phone (714) 399-6694

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10680TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ebf Eye Pro, LLC Optometrist PastSince Aug 28, 2022 Accepting new patients
Fadel Eye Pro, Inc. Optometrist PastSince Aug 28, 2022 Accepting new patients
FD&I Group, LLC Optometrist Past Accepting new patients

Organizations & group practices 3

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": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1487387767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 W CHATEAU AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928044505",
            "telephone_number": "714-399-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9595 SIX PINES DR STE 1350A",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773801531",
            "telephone_number": "281-298-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAM",
        "first_name": "TAWNYA",
        "middle_name": "ALAYNA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.