Individual provider Active NPI

Emma Anne Lee, O.D.

  • Optometrist
  • La Porte, TX
National Provider Identifier
1538215504
Registry record updated Apr 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5418TG Issued in TX
Practice address
10411 W Fairmont Pkwy
La Porte, TX 77571-6014
Phone
(281) 991-6774
Fax
(832) 201-9836
NPI assigned
Jan 25, 2007
Last updated
Apr 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5418TG TX Primary

Addresses

Primary practice location

10411 W Fairmont Pkwy
La Porte, TX 77571-6014

Mailing address

10411 W Fairmont Pkwy
La Porte, TX 77571-6014
Phone (281) 991-6774

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
I20090612000088 TX Practitioner - Optometry 1850448135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bub-Lee Eye Center IncGroup PAC ID 0042367328, 2 clinicians

Practice addresses (Care Compare)

10411 W Fairmont Pkwy
La Porte, TX 77571-6014
Phone (281) 991-6774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bub-Lee Eye Center Inc Optometrist CurrentSince Apr 30, 2009 Accepting new patients

Locations

10411 W Fairmont Pkwy
La Porte, TX 77571
Phone (281) 991-6774

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397779200000",
    "number": "1538215504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10411 W FAIRMONT PKWY",
            "city": "LA PORTE",
            "state": "TX",
            "postal_code": "775716014",
            "telephone_number": "281-991-6774",
            "fax_number": "832-201-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10411 W FAIRMONT PKWY",
            "city": "LA PORTE",
            "state": "TX",
            "postal_code": "775716014",
            "telephone_number": "281-991-6774",
            "fax_number": "832-201-9836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "EMMA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2014-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5418TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Porte, TX

Sources for this page

Verify at the official NPI Registry.