Individual provider Active NPI

Viet Phan Ho, O.D.

  • Optometrist
  • Houston, TX
National Provider Identifier
1609022573
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TX5838 Issued in TX
Practice address
12924 Bellaire Blvd Ste 100
Houston, TX 77072-5132
Phone
(713) 457-2300
Fax
(713) 457-4200
NPI assigned
Aug 12, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 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 TX5838 TX Primary

Addresses

Primary practice location

12924 Bellaire Blvd Ste 100
Houston, TX 77072-5132

Mailing address

12924 Bellaire Blvd Ste 100
Houston, TX 77072-5132
Phone (713) 457-2300

Other identifiers 1

IdentifierTypeStateIssuer
147294601MedicaidTX

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
I20240919003104 TX Practitioner - Optometry 5092256875 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TX5838TXMDOptometrist

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": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1609022573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12924 BELLAIRE BLVD STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770725132",
            "telephone_number": "713-457-2300",
            "fax_number": "713-457-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12924 BELLAIRE BLVD STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770725132",
            "telephone_number": "713-457-2300",
            "fax_number": "713-457-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HO",
        "first_name": "VIET",
        "middle_name": "PHAN",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-12",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "TX5838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147294601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.