Khadija Fakhruddin Sutarwalla

Primary specialty

OptometristTaxonomy code 152W00000X

License

9918 Issued in TX

Practice address

190 Heights Blvd
Houston, TX 77007-3729

Phone

(713) 527-8480

Fax

(713) 743-0963

NPI assigned

Feb 17, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Optics Eyecare PLLC

  • Optometrist
  • Houston, TX
  • NPI 1316365273
  Medicare reassignment NPD
• University of Houston System

  dba University Eye Institute

  • Optometrist
  • Houston, TX
  • NPI 1861493140
  Medicare reassignment NPD
• University of Houston

  • Community Health Worker
  • Houston, TX
  • NPI 1366081622
  NPD
• University of Houston System

  • Speech-Language Pathologist
  • Houston, TX
  • NPI 1447371430
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1649803800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 HEIGHTS BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770073729",
            "telephone_number": "713-527-8480",
            "fax_number": "713-743-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 HEIGHTS BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770073729",
            "telephone_number": "713-527-8480",
            "fax_number": "713-743-0963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4901 Calhoun Rd",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "772042020",
            "country_code": "US",
            "telephone_number": "713-743-2020",
            "fax_number": "713-743-0963",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTARWALLA",
        "first_name": "KHADIJA",
        "middle_name": "FAKHRUDDIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-17",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xiomara Sustaita
• Michelle Sutanto, MD
• Ayush Sutaria, M.D.
• Neil Sutaria, M.D.
• Rachana Sutaria, M.D.
• Bernhard Suter, M.D.
• Rachel Marie Suter, MD
• Charles E. Sutherland, D.D.S.
• Courtney Siems Sutherland, MD
• Elizabeth Wylie Sutherland, PA-C

• Optometrist in Houston, TX
• Providers in Houston, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.