Individual provider Active NPI

Vang Thi Pham, OD

  • Optometrist
  • Houston, TX
National Provider Identifier
1639341498
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6971TG Issued in TX
Practice address
12620 Woodforest Blvd Ste 140
Houston, TX 77015-3561
Phone
(281) 540-7040
NPI assigned
Apr 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy Optometrist 152WV0400X 6971TG TX
Optometrist 152W00000X 6971TG TX Primary

Addresses

Primary practice location

12620 Woodforest Blvd Ste 140
Houston, TX 77015-3561

Mailing address

602 Royal Oaks Dr
Friendswood, TX 77546-7006
Phone (832) 814-2344

Other practice location 1

20131 Highway 59 N Ste 1140
Humble, TX 77338-2331
Phone (281) 540-7040

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
I20211028000112 TX Practitioner - Optometry 0547658346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12620 Woodforest Blvd
Suite 140
Houston, TX 77015-3561
Phone (281) 540-7040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6971TGTXMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
My Eye Care LLC Optometrist CurrentSince Mar 1, 2023 Accepting new patients

Locations

12620 Woodforest Blvd
Ste 140
Houston, TX 77015
Phone (281) 540-7040

Organizations & group practices 2

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": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1639341498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 ROYAL OAKS DR",
            "city": "FRIENDSWOOD",
            "state": "TX",
            "postal_code": "775467006",
            "telephone_number": "832-814-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12620 WOODFOREST BLVD STE 140",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770153561",
            "telephone_number": "281-540-7040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20131 Highway 59 N Ste 1140",
            "address_purpose": "LOCATION",
            "city": "Humble",
            "state": "TX",
            "postal_code": "773382331",
            "country_code": "US",
            "telephone_number": "281-540-7040",
            "fax_number": "281-540-7042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "VANG",
        "middle_name": "THI",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "TX",
            "license": "6971TG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6971TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.